42 C.F.R. § 478.20   Time limits for requesting reconsideration.


Title 42 - Public Health


Title 42: Public Health
PART 478—RECONSIDERATIONS AND APPEALS
Subpart B—Utilization and Quality Control Quality Improvement Organization (QIO) Reconsiderations and Appeals

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§ 478.20   Time limits for requesting reconsideration.

(a) Basic rules. (1) Except for a request for expedited reconsideration as provided in paragraph (c) of this section, or a late request with good cause under §473.22, a dissatisfied party must file a request for reconsideration within 60 days after receipt of the notice of an initial determination.

(2) The date of receipt of the notice of the initial determination is presumed to be five days after the date on the notice, unless there is a reasonable showing to the contrary.

(3) A request is considered filed on the date it is postmarked.

(b) Late filing of request. A QIO will accept a request filed after 60 days after receipt of the notice of the initial determination if the QIO finds under the criteria set forth in §473.22 that there was good cause for the party's failure to file a timely request.

(c) Request for expedited reconsideration. A request for an expedited reconsideration under §473.18(c) must be submitted within three days after receipt of the notice of the initial denial determination.

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