42 CFR §478.24
Verified against eCFR.gov as of June 20, 2026View official text on eCFR.gov ↗
- (a)Subject to the rules concerning disclosure of QIO information in section 1160 of the Act, at the request of a provider, practitioner or beneficiary, the QIO must provide an opportunity for examination of the material upon which the initial denial determination was based. The QIO may not furnish a provider, practitioner or beneficiary with—
- (b)The QIO may require the requester to pay a reasonable fee for the reproduction of the material requested.
- (c)The QIO must provide a party with an opportunity to submit new evidence before the reconsidered determination is made.