Regulations last checked for updates: Nov 24, 2024

Title 42 - Public Health last revised: Nov 19, 2024
§ 478.18 - Location for submitting requests for reconsideration.

(a) Beneficiaries. Except as provided in paragraph (c) of this section concerning requests for expedited reconsideration, a beneficiary who wishes to obtain a reconsideration must submit a written request to one of the following:

(1) The QIO or the QIO subcontractor that made the initial determination.

(2) An SSA District Office.

(3) A Railroad Retirement Board Office, if the beneficiary is a railroad retiree.

(b) Others. A provider, physician or other practitioner that wishes to obtain reconsideration must submit a written request to the QIO or QIO subcontractor that made the initial determination.

(c) Expedited reconsideration. A request for an expedited reconsideration of a preadmission denial determination must be submitted directly to the QIO.

authority: Secs. 1102 and 1871 of the Social Security Act (42 U.S.C. 1302 and 1395hh)
cite as: 42 CFR 478.18