# 42 CFR § 411.2: Conclusive effect of QIO determinations on payment of claims

> Federal · Regulations · In force

URL: https://www.frixlaw.com/law-library/statutes/ecfr-42-411.2

## Section

- **Citation:** 42 CFR § 411.2
- **Heading:** Conclusive effect of QIO determinations on payment of claims
- **Jurisdiction:** Federal
- **Kind:** Regulations
- **Status:** In force
- **Text as of:** September 22, 2026
- **Source:** Publisher's official text
- **Location:** Title 42—Public Health > CHAPTER IV—CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES > SUBCHAPTER B—MEDICARE PROGRAM > PART 411—EXCLUSIONS FROM MEDICARE AND LIMITATIONS ON MEDICARE PAYMENT > Subpart A—General Exclusions and Exclusion of Particular Services

## Text

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.

## Nearby sections

- [42 CFR § 411.1 § 411.1 Basis and scope.](https://www.frixlaw.com/law-library/statutes/ecfr-42-411.1.md)
- [42 CFR § 411.2 § 411.2 Conclusive effect of QIO determinations on payment of claims.](https://www.frixlaw.com/law-library/statutes/ecfr-42-411.2.md)
- [42 CFR § 411.4 § 411.4 Items and services for which neither the beneficiary nor any other person is legally obligated to pay.](https://www.frixlaw.com/law-library/statutes/ecfr-42-411.4.md)
- [42 CFR § 411.6 § 411.6 Services furnished by a Federal provider of services or other Federal agency.](https://www.frixlaw.com/law-library/statutes/ecfr-42-411.6.md)
- [42 CFR § 411.7 § 411.7 Services that must be furnished at public expense under a Federal law or Federal Government contract.](https://www.frixlaw.com/law-library/statutes/ecfr-42-411.7.md)
- [42 CFR § 411.8 § 411.8 Services paid for by a Government entity.](https://www.frixlaw.com/law-library/statutes/ecfr-42-411.8.md)
- [42 CFR § 411.9 § 411.9 Services furnished outside the United States.](https://www.frixlaw.com/law-library/statutes/ecfr-42-411.9.md)
- [42 CFR § 411.10 § 411.10 Services required as a result of war.](https://www.frixlaw.com/law-library/statutes/ecfr-42-411.10.md)
- [42 CFR § 411.12 § 411.12 Charges imposed by an immediate relative or member of the beneficiary's household.](https://www.frixlaw.com/law-library/statutes/ecfr-42-411.12.md)
- [42 CFR § 411.15 § 411.15 Particular services excluded from coverage.](https://www.frixlaw.com/law-library/statutes/ecfr-42-411.15.md)
- [42 CFR § 411.20 § 411.20 Basis and scope.](https://www.frixlaw.com/law-library/statutes/ecfr-42-411.20.md)
- [42 CFR § 411.21 § 411.21 Definitions.](https://www.frixlaw.com/law-library/statutes/ecfr-42-411.21.md)
- [42 CFR § 411.22 § 411.22 Reimbursement obligations of primary payers and entities that received payment from primary payers.](https://www.frixlaw.com/law-library/statutes/ecfr-42-411.22.md)
- [42 CFR § 411.23 § 411.23 Beneficiary's cooperation.](https://www.frixlaw.com/law-library/statutes/ecfr-42-411.23.md)

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Source: Frix Law Library, https://www.frixlaw.com/law-library/statutes/ecfr-42-411.2. Check the current official text before relying on it. Not legal advice.