Subpart B—Utilization and Quality Control Quality Improvement Organization (QIO) Reconsiderations and Appeals
- §478.10 Scope.
- §478.12 Statutory basis.
- §478.14 Applicability.
- §478.15 QIO review of changes resulting from DRG validation.
- §478.16 Right to reconsideration.
- §478.18 Location for submitting requests for reconsideration.
- §478.20 Time limits for requesting reconsideration.
- §478.22 Good cause for late filing of a request for a reconsideration or hearing.
- §478.24 Opportunity for a party to obtain and submit information.
- §478.26 Delegation of the reconsideration function.
- §478.28 Qualifications of a reconsideration reviewer.
- §478.30 Evidence to be considered by the reconsideration reviewer.
- §478.32 Time limits for issuance of the reconsidered determination.
- §478.34 Notice of a reconsidered determination.
- §478.36 Record of reconsideration.
- §478.38 Effect of a reconsidered determination.
- §478.40 Beneficiary's right to a hearing.
- §478.42 Submitting a request for a hearing.
- §478.44 Determining the amount in controversy for a hearing.
- §478.46 Medicare Appeals Council and judicial review.
- §478.48 Reopening and revision of a reconsidered determination or a decision.