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Regulations last checked for updates: Nov 23, 2025
Title 42 - Public Health last revised: Oct 01, 2025
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Title 42
Chapter IV
Part 423
Subpart M - 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.
authority:
42 U.S.C. 1302
,
1306
,
1395w
,
and
source:
70 FR 4525, Jan. 28, 2005, unless otherwise noted.
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