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Code of Federal Regulations (Last Updated: July 5, 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 |
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Subpart B - Utilization and Quality Control Quality Improvement Organization (QIO) Reconsiderations and Appeals |
§ 478.42 - Submitting a request for a hearing.
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§ 478.42 Submitting a request for a hearing.
((a) Where to submit the written request. A beneficiary who wants to obtain a hearing under § 478.40 must submit a written request to one of the following:
(1) The officethe OMHA office identified in the notice of the QIO
or QIO subcontractor that made the initial determination.(2) A SSA District Office.
(3) An office of the Office of Hearings and Appeals of SSA.
(4) An office of the Railroad Retirement Board, in the case of a beneficiary who is a railroad retiree.
reconsidered determination.
(b) Time limit for submitting a request for a hearing.
(1) The request for a hearing must be filed within 60 calendar days of receipt of the notice of the QIO reconsidered determination, unless the time is extended for good cause as provided in § 478.22.
(2) The date of receipt of the notice of the reconsidered determination is presumed to be five 5 calendar days after the date on the notice, unless there is a reasonable showing evidence to the contrary.
(3) A request is considered filed on the date it is postmarkedreceived by OMHA.
[50 82 FR 153305139, AprJan. 17, 1985, as amended at 77 FR 68563, Nov. 15, 20122017]