§423.2600. Payment appeals.
42 C.F.R. § 423.2600
Medicare Part D plan sponsors may appeal program integrity prescription drug event record review audit determinations.
Issues eligible for appeal.
CMS's application of Part D policy(ies).
Factual or data errors.
Issues ineligible for appeal.
The Part D plan sponsor's failure to submit documentation in the timeframes specified by CMS during the audit.
The program integrity prescription drug event record review audit methodology.
Notes, amendments, and revision history
Amendments
[91 FR 17594, Apr. 6, 2026]
Source
Source: 79 FR 29967, May 23, 2014, unless otherwise noted.
Authority
Authority: 42 U.S.C. 1302, 1306, 1395w-101 through 1395w-152, and 1395hh.
Source
Source: 70 FR 4525, Jan. 28, 2005, unless otherwise noted.
Amendments
[91 FR 17594, Apr. 6, 2026]