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- Code of Federal Regulations
- C.F.R. 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 B—Utilization and Quality Control Quality Improvement Organization (QIO) Reconsiderations and Appeals
42 C.F.R. § 478.28
Qualifications of a reconsideration reviewer.
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Source: 50 FR 15330, Apr. 17, 1985, as amended at 77 FR 68563, Nov. 15, 2012
Table of Contents
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.