42 CFR 411.2
§ 411.2 Conclusive effect of QIO determinations on payment of claims.
United States · 42 CFR — Public Health · Status: effective
Cite this
- Citation
- 42 CFR 411.2, § 411.2 Conclusive effect of QIO determinations on payment of claims, United States, version 1 as recorded 2026-07-09, yourstate.us, https://yourstate.us/provision/203394
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Full text
If a utilization and quality control quality improvement organization (QIO) has assumed review responsibility, in accordance with part 466 of this chapter, for services furnished to Medicare beneficiaries, Medicare payment is not made for those services unless the conditions of subpart C of part 466 of this chapter are met.
Legislative history
This is a federal regulation, adopted through agency rulemaking under the Administrative Procedure Act — not enacted by a recorded vote of Congress.