SUBPART M—Grievances, Coverage Determinations, Redeterminations, and Reconsiderations (§423.558 to §423.638)
- 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.
- 423.636—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.