42 CFR 476.85 - Conclusive effect of QIO initial denial determinations and changes as a result of DRG validations.

Regulations last checked for updates: Nov 24, 2024

Title 42 - Public Health last revised: Nov 19, 2024

View all text of Subpart C [§ 476.70 - § 476.170]

§ 476.85 - Conclusive effect of QIO initial denial determinations and changes as a result of DRG validations.

A QIO initial denial determination or change as a result of DRG validation is final and binding unless, in accordance with the procedures in part 473—

(a) The initial denial determination is reconsidered and revised; or

(b) The change as a result of DRG validation is reviewed and revised.

authority: 42 U.S.C. 1302 and 1395hh

source: 44 FR 32081, June 4, 1979, unless otherwise noted. Redesignated at 64 FR 66279, Nov. 24, 1999.

cite as: 42 CFR 476.85