42 CFR § 411.2 Exclusions from Medicare and Limitations on Medicare Payment

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

Current through Oct 8, 2026 · Read all of Part 411

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.

← § 411.1 Basis and scope.§ 411.4 Items and services for which neither the beneficiary nor any other person is legally obligated to pay. →