42 CFR Subpart M - Grievances, Coverage Determinations, Redeterminations, and Reconsiderations
- § 423.558 Scope.
- § 423.560 Definitions.
- § 423.562 General provisions.
- § 423.564 Grievance procedures.
- § 423.566 Coverage determinations.
- § 423.568 Standard timeframe and notice requirements for coverage determinations.
- § 423.570 Expediting certain coverage determinations.
- § 423.572 Timeframes and notice requirements for expedited coverage determinations.
- § 423.576 Effect of a coverage determination.
- § 423.578 Exceptions process.
- § 423.580 Right to a redetermination.
- § 423.582 Request for a standard redetermination.
- § 423.584 Expediting certain redeterminations.
- § 423.586 Opportunity to submit evidence.
- § 423.590 Timeframes and responsibility for making redeterminations.
- § 423.600 Reconsideration by an independent review entity (IRE).
- § 423.602 Notice of reconsideration determination by the independent review entity.
- § 423.604 Effect of a reconsideration determination.
- §§ 423.610-423.634 [Reserved]
- § 423.636 How a Part D plan sponsor must effectuate standard redeterminations, reconsiderations, or decisions.
- § 423.638 How a Part D plan sponsor must effectuate expedited redeterminations or reconsiderations.