§423.558. Scope.
42 C.F.R. § 423.558
This subpart sets forth the requirements relating to the following—
Part D plan sponsors with respect to grievances, coverage determinations, and redeterminations.
Part D IRE with respect to reconsiderations.
Part D enrollees' rights with respect to grievances, coverage determinations, redeterminations, and reconsiderations.
Review of at-risk determinations made under a drug management program in accordance with § 423.153(f).
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.
Notes, amendments, and revision history
Amendments
[74 FR 65363, Dec. 9, 2009, as amended at 82 FR 5125, Jan. 17, 2017; 83 FR 16750, Apr. 16, 2018]
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
[74 FR 65363, Dec. 9, 2009, as amended at 82 FR 5125, Jan. 17, 2017; 83 FR 16750, Apr. 16, 2018]