[Code of Federal Regulations]

[Title 42, Volume 2]

[Revised as of October 1, 2005]

From the U.S. Government Printing Office via GPO Access

[CITE: 42CFR411.2]



[Page 379]

 

                         TITLE 42--PUBLIC HEALTH

 

                    CHAPTER IV--CENTERS FOR MEDICARE

                          & MEDICAID SERVICES,

                        DEPARTMENT OF HEALTH AND

                             HUMAN SERVICES

 

PART 411_EXCLUSIONS FROM MEDICARE AND LIMITATIONS ON MEDICARE PAYMENT

--Table of Contents

 

    Subpart A_General Exclusions and Exclusion of Particular Services

 

Sec. 411.2  Conclusive effect of QIO determinations on payment of claims.



    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.