---
kind: "section"
citation: "42 C.F.R. § 478.32"
title: "42"
number: "478.32"
heading: "Time limits for issuance of the reconsidered determination."
url: "https://uscodex.org/cfr/42/478.32"
---

# §478.32. Time limits for issuance of the reconsidered determination.

- (a) **Beneficiaries.** If a beneficiary files a timely request for reconsideration of an initial denial determination, the QIO must complete its reconsidered determination and send written notice to the beneficiary within the following time limits—
  - (1) **Within three working days after the QIO receives the request for reconsideration if—**
    - (i) The beneficiary is still an inpatient in a hospital for the stay in question when the QIO receives the request for reconsideration; or
    - (ii) The initial determination relates to institutional services for which admission to the institution is sought, the initial determination was made before the patient was admitted to the institution; and a request was submitted timely for an expedited reconsideration.
  - (2) Within 10 working days after the QIO receives the request for reconsideration if the beneficiary is still an inpatient in a SNF for the stay in question when the QIO receives the request for reconsideration.
  - (3) **Within 30 working days after the QIO receives the request for reconsideration if—**
    - (i) The initial determination concerns ambulatory or noninstitutional services;
    - (ii) The beneficiary is no longer an inpatient in a hospital or SNF for the stay in question; or
    - (iii) **The beneficiary does not submit a request for expedited reconsideration timely.**
- (b) **Providers or practitioners.** If the provider or practitioner files a request for reconsideration of an initial determination, the QIO must complete its reconsidered determination and send written notice to the provider or practitioner within 30 working days.

## Notes

### Source

Source: 50 FR 15372, Apr. 17, 1985, unless otherwise noted. Redesignated at 64 FR 66279, Nov. 24, 1999.

### Authority

Authority: Secs. 1102 and 1871 of the Social Security Act (42 U.S.C. 1302 and 1395hh).