---
kind: "section"
citation: "45 C.F.R. § 800.502"
title: "45"
number: "800.502"
heading: "MSP issuer internal claims and appeals."
url: "https://uscodex.org/cfr/45/800.502"
---

# §800.502. MSP issuer internal claims and appeals.

- (a) **Processes.** MSP issuers must comply with the internal claims and appeals processes applicable to group health plans and health insurance issuers under [45 CFR 147.136(b)](/cfr/45/147.136.md?p=b).
- (b) **Timeframes and notice of determination.** An MSP issuer must provide written notice to an enrollee of its determination on a claim brought under [paragraph (a)](#a) of this section according to the timeframes and notification rules under 45 CFR [147.136(b)](/cfr/45/147.136.md?p=b) and [(e)](/cfr/45/147.136.md?p=e), including the timeframes for urgent claims. If the MSP issuer denies a claim (or a portion of the claim), the enrollee may appeal the adverse benefit determination to the MSP issuer in accordance with [45 CFR 147.136(b)](/cfr/45/147.136.md?p=b).

## Notes

### Authority

Authority: Sec. 1334 of Pub. L. 111-148, 124 Stat. 119; Pub. L. 111-152, 124 Stat. 1029 (42 U.S.C. 18054).

### Source

Source: 80 FR 9655, Feb. 24, 2015; 80 FR 16577, Mar. 30, 2015, unless otherwise noted.