Code of Federal Regulations (Last Updated: July 5, 2024) |
Title 42 - Public Health |
Chapter IV - Centers for Medicare & Medicaid Services, Department of Health and Human Services |
SubChapter D - State Children'S Health Insurance Programs (Schips) |
Part 473 - RECONSIDERATIONS AND APPEALS |
Subpart B - Utilization and Quality Control Peer Review Organization (PRO) Reconsiderations and Appeals |
§ 473.38 - Effect of a reconsidered determination.
Latest version.
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A PRO reconsidered determination is binding upon all parties to the reconsideration unless—
(a) A hearing is requested in accordance with § 473.40 and a final decision rendered; or
(b) The reconsidered determination is later reopened and revised in accordance with § 473.48.