---
kind: "section"
citation: "42 C.F.R. § 423.580"
title: "42"
number: "423.580"
heading: "Right to a redetermination."
url: "https://uscodex.org/cfr/42/423.580"
---

# §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](/cfr/42/423.1978.md)) or an at-risk determination under a drug management program in accordance with [§ 423.153(f)](/cfr/42/423.153.md?p=f) may request that it be redetermined under the procedures described in [§ 423.582](/cfr/42/423.582.md), 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](/cfr/42/423.582.md). 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](/cfr/42/423.584.md).


## Notes

### Amendments

[83 FR 16752, 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

[83 FR 16752, Apr. 16, 2018]