Clinical guidelines,

Clinical guidelines, for the purposes of a drug management program under 423.153, are criteria -
(1) To identify potential at-risk beneficiaries who may be determined to be at-risk beneficiaries under such programs; and
(2) That are developed in accordance with the standards in ยง 423.153(f)(16) and, beginning with contract year 2020, will be published in guidance annually.


42 CFR § 423.100

Scoping language

As used in this part, unless otherwise specified-

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