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Regulations last checked for updates: May 23, 2025

Title 42 - Public Health last revised: May 16, 2025
All TitlesTitle 42Chapter IVPart 438Subpart F - Subpart F—Grievance and Appeal System
  • § 438.400 - Statutory basis, definitions, and applicability.
  • § 438.402 - General requirements.
  • § 438.404 - Timely and adequate notice of adverse benefit determination.
  • § 438.406 - Handling of grievances and appeals.
  • § 438.408 - Resolution and notification: Grievances and appeals.
  • § 438.410 - Expedited resolution of appeals.
  • § 438.414 - Information about the grievance and appeal system to providers and subcontractors.
  • § 438.416 - Recordkeeping requirements.
  • § 438.420 - Continuation of benefits while the MCO, PIHP, or PAHP appeal and the State fair hearing are pending.
  • § 438.424 - Effectuation of reversed appeal resolutions.
authority: 42 U.S.C. 1302.
source: 67 FR 41095, June 14, 2002, unless otherwise noted.
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