Subpart B—Utilization and Quality Control Quality Improvement Organization (QIO) Reconsiderations and Appeals

1. CFR
2. ›
3. Title 42
4. ›
5. Chapter IV
6. ›
7. Part 478
8. ›
9. Subpart B

Sections

Section numbering in the official eCFR can be non-consecutive. Omitted section numbers are not treated here as reserved unless the source explicitly labels them that way.

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