42 CFR 478.16 - Right to reconsideration.

Regulations last checked for updates: May 01, 2025

Title 42 - Public Health last revised: Apr 15, 2025

View all text of Subpart B [§ 478.10 - § 478.48]

§ 478.16 - Right to reconsideration.

A beneficiary, provider or practitioner who is dissatisfied with a QIO initial denial determination on one of the issues specified in § 478.14 has a right to a reconsideration of that determination by the QIO that made the initial denial determination.

[50 FR 15330, Apr. 17, 1985, as amended at 77 FR 68563, Nov. 15, 2012]

authority: Secs. 1102 and 1871 of the Social Security Act (42 U.S.C. 1302 and 1395hh)

cite as: 42 CFR 478.16