Federal (United States) · Regulations
Subpart M — Grievances, Coverage Determinations, Redeterminations, and Reconsiderations
20 sections
20 sections
- 42 C.F.R. § 423.558Scope.
- 42 C.F.R. § 423.560Definitions.
- 42 C.F.R. § 423.562General provisions.
- 42 C.F.R. § 423.564Grievance procedures.
- 42 C.F.R. § 423.566Coverage determinations.
- 42 C.F.R. § 423.568Standard timeframe and notice requirements for coverage determinations.
- 42 C.F.R. § 423.570Expediting certain coverage determinations.
- 42 C.F.R. § 423.572Timeframes and notice requirements for expedited coverage determinations.
- 42 C.F.R. § 423.576Effect of a coverage determination.
- 42 C.F.R. § 423.578Exceptions process.
- 42 C.F.R. § 423.580Right to a redetermination.
- 42 C.F.R. § 423.582Request for a standard redetermination.
- 42 C.F.R. § 423.584Expediting certain redeterminations.
- 42 C.F.R. § 423.586Opportunity to submit evidence.
- 42 C.F.R. § 423.590Timeframes and responsibility for making redeterminations.
- 42 C.F.R. § 423.600Reconsideration by an independent review entity (IRE).
- 42 C.F.R. § 423.602Notice of reconsideration determination by the independent review entity.
- 42 C.F.R. § 423.604Effect of a reconsideration determination.
- 42 C.F.R. § 423.636How a Part D plan sponsor must effectuate standard redeterminations, reconsiderations, or decisions.
- 42 C.F.R. § 423.638How a Part D plan sponsor must effectuate expedited redeterminations or reconsiderations.