US · guidance
CMS Pub. 100-04, ch. 30, § 200.4.3
Untimely Requests for Review
Untimely request timeframes
Beneficiary location BFCC-QIO determination
Beneficiary in hospital
[may request expedited review anytime while
in hospital]
BFCC-QIO will make its determination
and notify the beneficiary, the hospital,
and the physician of its determination
within 2 calendar days after it receives all
requested information.
Beneficiary left hospital
[may request expedited review within 30 days
of discharge]
BFCC-QIO will make its determination
and notify the beneficiary, the hospital,
and the physician of its determination
within 30 calendar days after it receives
all requested information.
The coverage protections discussed in §200.4.2 do not apply to a beneficiary who makes
an untimely request to the BFCC-QIO.
History
(Rev. 11210; Issued: 01-21-2022; Effective: 04-21-2022; Implementation: 04-21- 2022)
Provenance
- Source
- cms.gov
- Retrieved
- 2026-08-25
- Edition
- iom-2026-08-25
- Content hash
c8bdbc033761627ce343c7a1f46a2d2400ee8a117974e886ded90f849692c0e7
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