42 CFR §488.1130

1. (a)Opportunity to refute survey findings. Upon the provider's receipt of an official statement of deficiencies, hospice programs can request an informal opportunity to dispute condition-level survey findings.
2. (b)Failure to conduct IDR timely. Failure of CMS, the State, or the AO, as appropriate, to complete IDR must not delay the effective date of any enforcement action.
3. (c)Revised statement of deficiencies as a result of IDR. If any findings are revised or removed by CMS, the State, or the AO based on IDR, the official statement of deficiencies is revised accordingly, and any enforcement actions imposed solely as a result of those cited deficiencies are adjusted accordingly.
4. (d)Notification.
   1. (1)If the survey findings indicate a condition-level deficiency, the hospice program is notified in writing of its opportunity for participating in an IDR process at the time the official statement of deficiencies is issued.
   2. (2)The request for IDR must—
      1. (i)Be submitted in writing;
      2. (ii)Include the specific deficiencies that are disputed; and
      3. (iii)Be made within the same 10 calendar day period that the hospice program has for submitting an acceptable plan of correction.