42 CFR § 478.16 - Right to reconsideration.

---
identifier: "/us/cfr/t42/s478.16"
source: "ecfr"
legal_status: "authoritative_unofficial"
title: "42 CFR § 478.16 - Right to reconsideration."
title_number: 42
title_name: "Public Health"
section_number: "478.16"
section_name: "Right to reconsideration."
chapter_name: "CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES"
subchapter_number: "F"
subchapter_name: "QUALITY IMPROVEMENT ORGANIZATIONS"
part_number: "478"
part_name: "RECONSIDERATIONS AND APPEALS"
positive_law: false
currency: "2026-03-24"
last_updated: "2026-03-24"
format_version: "1.1.0"
generator: "[email protected]"
authority: "Secs. 1102 and 1871 of the Social Security Act (42 U.S.C. 1302 and 1395hh)."
cfr_part: "478"
---


# 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]