---
kind: "section"
citation: "42 C.F.R. § 438.228"
title: "42"
number: "438.228"
heading: "Grievance and appeal systems."
url: "https://uscodex.org/cfr/42/438.228"
---

# §438.228. Grievance and appeal systems.

- (a) The State must ensure, through its contracts, that each MCO, PIHP, and PAHP has in effect a grievance and appeal system that meets the requirements of subpart F of this part.
- (b) If the State delegates to the MCO, PIHP, or PAHP responsibility for notice of action under [subpart E of part 431](/cfr/42/part431-subpartE.md) of this chapter, the State must conduct random reviews of each delegated MCO, PIHP, or PAHP and its providers and subcontractors to ensure that they are notifying enrollees in a timely manner.

## Notes

### Source

Source: 81 FR 27853, May 6, 2016, unless otherwise noted.

### Authority

Authority: 42 U.S.C. 1302.

### Source

Source: 67 FR 41095, June 14, 2002, unless otherwise noted.