Subpart C. Subpart C—Benefits and Beneficiary Protections
- § 422.100 - General requirements.
- § 422.101 - Requirements relating to basic benefits.
- § 422.102 - Supplemental benefits.
- § 422.103 - Benefits under an MA MSA plan.
- § 422.104 - Special rules on supplemental benefits for MA MSA plans.
- § 422.105 - Special rules for self-referral and point of service option.
- § 422.106 - Coordination of benefits with employer or union group health plans and Medicaid.
- § 422.107 - Requirements for dual eligible special needs plans.
- § 422.108 - Medicare secondary payer (MSP) procedures.
- § 422.109 - Effect of national coverage determinations (NCDs) and legislative changes in benefits; coverage of clinical trials and A and B device trials.
- § 422.110 - Discrimination against beneficiaries prohibited.
- § 422.111 - Disclosure requirements.
- § 422.112 - Access to services.
- § 422.113 - Special rules for ambulance services, emergency and urgently needed services, and maintenance and post-stabilization care services.
- § 422.114 - Access to services under an MA private fee-for-service plan.
- § 422.116 - Network adequacy.
- § 422.118 - Confidentiality and accuracy of enrollee records.
- § 422.119 - Access to and exchange of health data and plan information.
- § 422.120 - Access to published provider directory information.
- § 422.121 - Access to and exchange of health data for providers and payers.
- § 422.122 - Prior authorization requirements.
- § 422.125 - Resolution of complaints in a Complaints Tracking Module.
- § 422.128 - Information on advance directives.
- § 422.132 - Protection against liability and loss of benefits.
- § 422.133 - Return to home skilled nursing facility.
- § 422.134 - Reward and incentive programs.
- § 422.135 - Additional telehealth benefits.
- § 422.136 - Medicare Advantage (MA) and step therapy for Part B drugs.
- § 422.137 - Medicare Advantage Utilization Management Committee.
- § 422.138 - Prior authorization.