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Home Page > Executive Branch > Code of Federal Regulations > Electronic Code of Federal Regulations
e-CFR Data is current as of February 4, 2010
TITLE 42--Public Health
CHAPTER IV--CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES
SUBCHAPTER F--QUALITY IMPROVEMENT ORGANIZATIONS
PART 478--RECONSIDERATIONS AND APPEALS
Subpart A--[RESERVED]
Subpart B--UTILIZATION AND QUALITY CONTROL QUALITY IMPROVEMENT ORGANIZATION (QIO) RECONSIDERATIONS AND APPEALS
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| QIO review of changes resulting from DRG validation. |
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| Right to reconsideration. |
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| Location for submitting requests for reconsideration. |
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| Time limits for requesting reconsideration. |
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| Good cause for late filing of a request for a reconsideration or hearing. |
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| Opportunity for a party to obtain and submit information. |
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| Delegation of the reconsideration function. |
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| Qualifications of a reconsideration reviewer. |
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| Evidence to be considered by the reconsideration reviewer. |
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| Time limits for issuance of the reconsidered determination. |
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| Notice of a reconsidered determination. |
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| Record of reconsideration. |
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| Effect of a reconsidered determination. |
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| Beneficiary's right to a hearing. |
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| Submitting a request for a hearing. |
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| Determining the amount in controversy for a hearing. |
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| Departmental Appeals Board and judicial review. |
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| Reopening and revision of a reconsidered determination or a hearing decision. |
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