Title 42, Part 478 — Reconsiderations and Appeals
21 sections
Section 478.10
Scope.
Section 478.12
Statutory basis.
Section 478.14
Applicability.
Section 478.15
QIO review of changes resulting from DRG validation.
Section 478.16
Right to reconsideration.
Section 478.18
Location for submitting requests for reconsideration.
Section 478.20
Time limits for requesting reconsideration.
Section 478.22
Good cause for late filing of a request for a reconsideration or hearing.
Section 478.24
Opportunity for a party to obtain and submit information.
Section 478.26
Delegation of the reconsideration function.
Section 478.28
Qualifications of a reconsideration reviewer.
Section 478.30
Evidence to be considered by the reconsideration reviewer.
Section 478.32
Time limits for issuance of the reconsidered determination.
Section 478.34
Notice of a reconsidered determination.
Section 478.36
Record of reconsideration.
Section 478.38
Effect of a reconsidered determination.
Section 478.40
Beneficiary's right to a hearing.
Section 478.42
Submitting a request for a hearing.
Section 478.44
Determining the amount in controversy for a hearing.
Section 478.46
Medicare Appeals Council and judicial review.
Section 478.48
Reopening and revision of a reconsidered determination or a decision.