42 C.F.R. § 478.36 Record of reconsideration.
Title 42 - Public Health
(a) QIO requirements. A QIO must maintain the record of its reconsideration until the later of the following: (1) Four years after the date on the notice of the QIO's reconsidered determination. (2) Completion of litigation and the passage of the time period for filing all appeals. (b) Contents of the record. The record of the reconsideration must include: (1) The initial determination. (2) The basis for the initial determination. (3) Documentation of the date of the receipt of the request for reconsideration. (4) The detailed basis for the reconsidered determination. (5) Evidence submitted by the parties. (6) A copy of the notice of the reconsidered determination that was provided to the parties. (7) Documentation of the delivery or mailing and, if appropriate, the receipt of the notice of the reconsidered determination by the parties. (c) Confidentiality. The record of a QIO reconsideration is subject to prohibitions against disclosure of information as specified in section 1160 of the Act.
Title 42: Public Health
PART 478—RECONSIDERATIONS AND APPEALS
Subpart B—Utilization and Quality Control Quality Improvement Organization (QIO) Reconsiderations and Appeals
§ 478.36 Record of reconsideration.
