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Code of Federal Regulations (Last Updated: November 8, 2024) |
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Title 42 - Public Health |
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Chapter IV - Centers for Medicare & Medicaid Services, Department of Health and Human Services |
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SubChapter F - Quality Improvement Organizations |
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Part 478 - Reconsiderations and Appeals |
| Subpart A - XXX |
| Subpart B - Utilization and Quality Control Quality Improvement Organization (QIO) Reconsiderations and Appeals |
| § 478.10 - Scope. |
| § 478.12 - Statutory basis. |
| § 478.14 - Applicability. |
| § 478.15 - QIO review of changes resulting from DRG validation. |
| § 478.16 - Right to reconsideration. |
| § 478.18 - Location for submitting requests for reconsideration. |
| § 478.20 - Time limits for requesting reconsideration. |
| § 478.22 - Good cause for late filing of a request for a reconsideration or hearing. |
| § 478.24 - Opportunity for a party to obtain and submit information. |
| § 478.26 - Delegation of the reconsideration function. |
| § 478.28 - Qualifications of a reconsideration reviewer. |
| § 478.30 - Evidence to be considered by the reconsideration reviewer. |
| § 478.32 - Time limits for issuance of the reconsidered determination. |
| § 478.34 - Notice of a reconsidered determination. |
| § 478.36 - Record of reconsideration. |
| § 478.38 - Effect of a reconsidered determination. |
| § 478.40 - Beneficiary's right to a hearing. |
| § 478.42 - Submitting a request for a hearing. |
| § 478.44 - Determining the amount in controversy for a hearing. |
| § 478.46 - Medicare Appeals Council and judicial review. |
| § 478.48 - Reopening and revision of a reconsidered determination or a decision. |