Title 42

PART 478

Part 478 - Reconsiderations And Appeals

PART 478 - RECONSIDERATIONS AND APPEALS Authority:Secs. 1102 and 1871 of the Social Security Act (42 U.S.C. 1302 and 1395hh).

42:4.0.1.4.19.1SUBPART A
Subpart A [Reserved]
42:4.0.1.4.19.2SUBPART B
Subpart B - Utilization and Quality Control Quality Improvement Organization (QIO) Reconsiderations and Appeals
42:4.0.1.4.19.2.186.1SECTION 478.10
   478.10 Scope.
42:4.0.1.4.19.2.186.2SECTION 478.12
   478.12 Statutory basis.
42:4.0.1.4.19.2.186.3SECTION 478.14
   478.14 Applicability.
42:4.0.1.4.19.2.186.4SECTION 478.15
   478.15 QIO review of changes resulting from DRG validation.
42:4.0.1.4.19.2.186.5SECTION 478.16
   478.16 Right to reconsideration.
42:4.0.1.4.19.2.186.6SECTION 478.18
   478.18 Location for submitting requests for reconsideration.
42:4.0.1.4.19.2.186.7SECTION 478.20
   478.20 Time limits for requesting reconsideration.
42:4.0.1.4.19.2.186.8SECTION 478.22
   478.22 Good cause for late filing of a request for a reconsideration or hearing.
42:4.0.1.4.19.2.186.9SECTION 478.24
   478.24 Opportunity for a party to obtain and submit information.
42:4.0.1.4.19.2.186.10SECTION 478.26
   478.26 Delegation of the reconsideration function.
42:4.0.1.4.19.2.186.11SECTION 478.28
   478.28 Qualifications of a reconsideration reviewer.
42:4.0.1.4.19.2.186.12SECTION 478.30
   478.30 Evidence to be considered by the reconsideration reviewer.
42:4.0.1.4.19.2.186.13SECTION 478.32
   478.32 Time limits for issuance of the reconsidered determination.
42:4.0.1.4.19.2.186.14SECTION 478.34
   478.34 Notice of a reconsidered determination.
42:4.0.1.4.19.2.186.15SECTION 478.36
   478.36 Record of reconsideration.
42:4.0.1.4.19.2.186.16SECTION 478.38
   478.38 Effect of a reconsidered determination.
42:4.0.1.4.19.2.186.17SECTION 478.40
   478.40 Beneficiary's right to a hearing.
42:4.0.1.4.19.2.186.18SECTION 478.42
   478.42 Submitting a request for a hearing.
42:4.0.1.4.19.2.186.19SECTION 478.44
   478.44 Determining the amount in controversy for a hearing.
42:4.0.1.4.19.2.186.20SECTION 478.46
   478.46 Medicare Appeals Council and judicial review.
42:4.0.1.4.19.2.186.21SECTION 478.48
   478.48 Reopening and revision of a reconsidered determination or a decision.