§ 473.28 - Qualifications of a reconsideration reviewer.

Related Notices

Latest version.

A reconsideration reviewer must be someone who is—

(a) Qualified under § 466.98 of this chapter to make an initial determination.

(b) Not the individual who made the initial denial determination.

(c) A specialist in the type of services under review, except where meeting this requirement would compromise the effectiveness or efficiency of PRO review.

                    
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