§476.150. Abandoned complaints and reopening rights.
42 C.F.R. § 476.150
Abandoned complaints. If a Medicare beneficiary fails to participate or otherwise comply with the requirements of the beneficiary complaint review process and the QIO does not have sufficient information to complete its review, the QIO may determine that the complaint has been abandoned and—
Inform the parties that its complaint review will be discontinued; and
Inform the beneficiary of his or her right to resubmit a written complaint in accordance with the procedures in § 476.120.
Reopening complaint reviews. A QIO may reopen a Medicare beneficiary complaint review using the same procedures that the QIO would use for reopening initial denial determinations and changes as a result of DRG validation, as described in § 476.96.
Notes, amendments, and revision history
Amendments
[77 FR 68561, Nov. 15, 2012]
Source
Source: 50 FR 15330, Apr. 17, 1985, unless otherwise noted. Redesignated at 64 FR 66279, Nov. 24, 1999.
Authority
Authority: 42 U.S.C. 1302 and 1395hh.
Source
Source: 44 FR 32081, June 4, 1979, unless otherwise noted. Redesignated at 64 FR 66279, Nov. 24, 1999.
Amendments
[77 FR 68561, Nov. 15, 2012]