Code of Federal Regulations Title 42. Public Health § 42.417.838 Organization determinations

(a) Actions that are organization determinations. For purposes of §§ 417.830 through 417.840, an organization determination is a refusal to furnish or arrange for services, or reimburse the party for services provided to the beneficiary, on the grounds that the services are not covered by Medicare.

(b) Actions that are not organization determinations. The following are not organization determinations for purposes of §§ 417.830 through 417.840: