[Code of Federal Regulations] [Title 12, Volume 1] [Revised as of January 1, 2003] From the U.S. Government Printing Office via GPO Access [CITE: 42CFR476.83] [Page 455-456] TITLE 42--PUBLIC HEALTH CHAPTER IV--CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES--(Continued) PART 476--UTILIZATION AND QUALITY CONTROL REVIEW--Table of Contents Subpart C--Review Responsibilities of Utilization and Quality Control Quality Improvement Organizations (QIOs) Sec. 476.83 Initial denial determinations. A determination by a QIO that the health care services furnished or proposed to be furnished to a patient are not medically necessary, are not reasonable, or are not at the appropriate [[Page 456]] level of care, is an initial denial determination and is appealable under part 473 of this chapter.