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Code of Federal Regulations (Last Updated: May 6, 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 D - State Children'S Health Insurance Programs (Schips) |
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Part 473 - RECONSIDERATIONS AND APPEALS |
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Subpart B - Utilization and Quality Control Peer Review Organization (PRO) Reconsiderations and Appeals |
§ 473.16 - Right to reconsideration.
Latest version.
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A beneficiary, provider or practitioner who is dissatisfied with a PRO initial denial determination on one of the issues specified in § 473.14(a) has a right to a reconsideration of that determination by the PRO that made the initial denial determination.