Subpart M. Subpart M—Grievances, Coverage Determinations, Redeterminations, and Reconsiderations
- § 423.558 - Scope.
- § 423.560 - Definitions.
- § 423.562 - General provisions.
- § 423.564 - Grievance procedures.
- § 423.566 - Coverage determinations.
- § 423.568 - Standard timeframe and notice requirements for coverage determinations.
- § 423.570 - Expediting certain coverage determinations.
- § 423.572 - Timeframes and notice requirements for expedited coverage determinations.
- § 423.576 - Effect of a coverage determination.
- § 423.578 - Exceptions process.
- § 423.580 - Right to a redetermination.
- § 423.582 - Request for a standard redetermination.
- § 423.584 - Expediting certain redeterminations.
- § 423.586 - Opportunity to submit evidence.
- § 423.590 - Timeframes and responsibility for making redeterminations.
- § 423.600 - Reconsideration by an independent review entity (IRE).
- § 423.602 - Notice of reconsideration determination by the independent review entity.
- § 423.604 - Effect of a reconsideration determination.
- §§ 423.610-423.634 - §[Reserved]
- § 423.636 - How a Part D plan sponsor must effectuate standard redeterminations, reconsiderations, or decisions.
- § 423.638 - How a Part D plan sponsor must effectuate expedited redeterminations or reconsiderations.