42 CFR § 423.558 - Scope.
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§ 423.558 Scope.
(a) This subpart sets forth the requirements relating to the following:
(1) Part D plan sponsors with respect to grievances, coverage determinations, and redeterminations.
(2) Part D IRE with respect to reconsiderations.
(3) Part D enrollees' rights with respect to grievances, coverage determinations, redeterminations, and reconsiderations.
(4) Review of at-risk determinations made under a drug management program in accordance with § 423.153(f).
(b) The requirements regarding reopenings, ALJ hearings and ALJ and attorney adjudicator decisions, Council review, and judicial review are set forth in subpart U of this chapter.