§ 466.85 - Conclusive effect of PRO initial denial determinations and changes as a result of DRG validations.

Related Notices
- 98-4230. Proposed rule. 98-4230. Medicare Program; ``Without Fault'' and Waiver of Recovery from an Individual as it Applies to Medicare Overpayment Liability
- 94-21488. Final rule with comment period. 94-21488. Medicare Program; Changes to the Hospital Inpatient Prospective Payment Systems and FY 1995 Rates; Final Rule DEPARTMENT OF HEALTH AND HUMAN SERVICES

Latest version.

A PRO initial denial determination or change as a result of DRG validation is final and binding unless, in accordance with the procedures in part 473—

(a) The initial denial determination is reconsidered and revised; or

(b) The change as a result of DRG validation is reviewed and revised.

                    
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