Section 478.28 - Qualifications of a reconsideration reviewerA reconsideration reviewer must be someone who is-
(a) Qualified under § 476.98 of this chapter to make an initial determination.(b) Not the individual who made the initial denial determination.(c) A specialist in the type of services under review, except where meeting this requirement would compromise the effectiveness or efficiency of QIO review.50 FR 15330, Apr. 17, 1985, as amended at 77 FR 68563 , Nov. 15, 2012