Evidence to be considered by the reconsideration reviewer.

  1. Law
  2. CFR 42
  3. Public Health
  4. Centers for Medicare & Medicaid Services, Department of Health and Human Services
  5. Quality Improvement Organizations
  6. Reconsiderations and Appeals
  7. Utilization and Quality Control Quality Improvement Organization (QIO) Reconsiderations and Appeals
  8. Evidence to be considered by the reconsideration reviewer.

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§ 478.30 Evidence to be considered by the reconsideration reviewer.

A reconsidered determination must be based on -

(a) The information that led to the initial determination;

(b) New information found in the medical records; or

(c) Additional evidence submitted by a party.


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