1. LawStack
  2. Title 42 - Public Health
  3. Chapter IV - CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES
  4. Subchapter B - MEDICARE PROGRAM
  5. Part 411 - EXCLUSIONS FROM MEDICARE AND LIMITATIONS ON MEDICARE PAYMENT
  6. Subpart A - General Exclusions and Exclusion of Particular Services
  7. 42 CFR § 411.2
42 CFR § 411.2
Conclusive effect of QIO determinations on payment of claims
June 11, 2020
CFR

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.

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§ 411.1 Basis and scope
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§ 411.4 Services for which neither the beneficiary nor any other person is legally obligated to pay

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