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  1. LII
  2. Electronic Code of Federal Regulations (e-CFR)
  3. Title 42. Public Health
  4. Chapter IV. CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES
  5. Subchapter B. MEDICARE PROGRAM
  6. Part 423. VOLUNTARY MEDICARE PRESCRIPTION DRUG BENEFIT
  7. Subpart M. Grievances, Coverage Determinations, Redeterminations, and Reconsiderations

42 CFR Subpart M - Grievances, Coverage Determinations, Redeterminations, and Reconsiderations

  • CFR
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  1. § 423.558 Scope.
  2. § 423.560 Definitions.
  3. § 423.562 General provisions.
  4. § 423.564 Grievance procedures.
  5. § 423.566 Coverage determinations.
  6. § 423.568 Standard timeframe and notice requirements for coverage determinations.
  7. § 423.570 Expediting certain coverage determinations.
  8. § 423.572 Timeframes and notice requirements for expedited coverage determinations.
  9. § 423.576 Effect of a coverage determination.
  10. § 423.578 Exceptions process.
  11. § 423.580 Right to a redetermination.
  12. § 423.582 Request for a standard redetermination.
  13. § 423.584 Expediting certain redeterminations.
  14. § 423.586 Opportunity to submit evidence.
  15. § 423.590 Timeframes and responsibility for making redeterminations.
  16. § 423.600 Reconsideration by an independent review entity (IRE).
  17. § 423.602 Notice of reconsideration determination by the independent review entity.
  18. § 423.604 Effect of a reconsideration determination.
  19. §§ 423.610-423.634 [Reserved]
  20. § 423.636 How a Part D plan sponsor must effectuate standard redeterminations, reconsiderations, or decisions.
  21. § 423.638 How a Part D plan sponsor must effectuate expedited redeterminations or reconsiderations.

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