42 C.F.R. § 423.558

Current through September 30, 2024
Section 423.558 - Scope
(a) This subpart sets forth the requirements relating to the following:
(1) Part D plan sponsors with respect to grievances, coverage determinations, and redeterminations.
(2) Part D IRE with respect to reconsiderations.
(3) Part D enrollees' rights with respect to grievances, coverage determinations, redeterminations, and reconsiderations.
(4) Review of at-risk determinations made under a drug management program in accordance with § 423.153(f) .
(b) The requirements regarding reopenings, ALJ hearings and ALJ and attorney adjudicator decisions, Council review, and judicial review are set forth in subpart U of this chapter.

42 C.F.R. §423.558

74 FR 65363, Dec. 9, 2009, as amended at 82 FR 5125, Jan. 17, 2017; 83 FR 16750, Apr. 16, 2018
As amended at 82 FR 5125, 1/17/2017; as amended at 82 FR 5125, 1/17/2017; 83 FR 16750, 6/15/2018