42 C.F.R. § 423.580

Current through November 30, 2024
Section 423.580 - Right to a redetermination

An enrollee who has received a coverage determination (including one that is reopened and revised as described in § 423.1978 ) or an at-risk determination under a drug management program in accordance with § 423.153(f) may request that it be redetermined under the procedures described in § 423.582 , which address requests for a standard redetermination. The prescribing physician or other prescriber (acting on behalf of an enrollee), upon providing notice to the enrollee, may request a standard redetermination under the procedures described in § 423.582 . An enrollee or an enrollee's prescribing physician or other prescriber (acting on behalf of an enrollee) may request an expedited redetermination as specified in § 423.584 .

42 C.F.R. §423.580

83 FR 16752 , Apr. 16, 2018
83 FR 16752 , 6/15/2018