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- 42 CFR 422.2410 · General requirements.
- 42 CFR 422.2420 · Calculation of the medical loss ratio.
- 42 CFR 422.2430 · Activities that improve health care quality.
- 42 CFR 422.2440 · Credibility adjustment.
- 42 CFR 422.2450 · [Reserved]
- 42 CFR 422.2460 · Reporting requirements.
- 42 CFR 422.2470 · Remittance to CMS if the applicable MLR requirement is not met.
- 42 CFR 422.2480 · MLR review and non-compliance.
- 42 CFR 422.2490 · Release of Part C MLR data.
- 42 CFR 422.2600 · Payment appeals.
- 42 CFR 422.2605 · Request for reconsideration.
- 42 CFR 422.2610 · Hearing official review.
- 42 CFR 422.2615 · Review by the Administrator.
- 42 CFR 423.1 · Basis and scope.
- 42 CFR 423.4 · Definitions.
- 42 CFR 423.6 · Cost-sharing in beneficiary education and enrollment-related costs.
- 42 CFR 423.30 · Eligibility and enrollment.
- 42 CFR 423.32 · Enrollment process.
- 42 CFR 423.34 · Enrollment of low-income subsidy eligible individuals.
- 42 CFR 423.36 · Disenrollment process.
- 42 CFR 423.38 · Enrollment periods.
- 42 CFR 423.40 · Effective dates.
- 42 CFR 423.44 · Involuntary disenrollment from Part D coverage.
- 42 CFR 423.46 · Late enrollment penalty.
- 42 CFR 423.48 · Information about Part D.
- 42 CFR 423.56 · Procedures to determine and document creditable status of prescription drug coverage.
- 42 CFR 423.100 · Definitions.
- 42 CFR 423.104 · Requirements related to qualified prescription drug coverage.
- 42 CFR 423.112 · Establishment of prescription drug plan service areas.
- 42 CFR 423.120 · Access to covered Part D drugs.
- 42 CFR 423.124 · Special rules for out-of-network access to covered Part D drugs at out-of-network pharmacies.
- 42 CFR 423.128 · Dissemination of Part D plan information.
- 42 CFR 423.129 · Resolution of complaints in complaints tracking module.
- 42 CFR 423.132 · Public disclosure of pharmaceutical prices for equivalent drugs.
- 42 CFR 423.136 · Privacy, confidentiality, and accuracy of enrollee records.
- 42 CFR 423.137 · Medicare Prescription Payment Plan.
- 42 CFR 423.150 · Scope.
- 42 CFR 423.153 · Drug utilization management, quality assurance, medication therapy management (MTM) programs, drug management programs, and access to Medicare Parts A and B claims data extracts.
- 42 CFR 423.154 · Appropriate dispensing of prescription drugs in long-term care facilities under PDPs and MA-PD plans.
- 42 CFR 423.156 · Consumer satisfaction surveys.
- 42 CFR 423.159 · Electronic prescription drug program.
- 42 CFR 423.160 · Standards for electronic prescribing.
- 42 CFR 423.162 · Quality improvement organization activities.
- 42 CFR 423.165 · Compliance deemed on the basis of accreditation.
- 42 CFR 423.168 · Accreditation organizations.
- 42 CFR 423.171 · Procedures for approval of accreditation as a basis for deeming compliance.
- 42 CFR 423.180 · Basis and scope of the Part D Prescription Drug Plan Quality Rating System.
- 42 CFR 423.182 · Part D Prescription Drug Plan Quality Rating System.
- 42 CFR 423.184 · Adding, updating, and removing measures.
- 42 CFR 423.186 · Calculation of Star Ratings.
- 42 CFR 423.251 · Scope.
- 42 CFR 423.258 · Definitions.
- 42 CFR 423.265 · Submission of bids and related information.
- 42 CFR 423.272 · Review and negotiation of bid and approval of plans submitted by potential Part D sponsors.
- 42 CFR 423.279 · National average monthly bid amount.
- 42 CFR 423.286 · Rules regarding premiums.
- 42 CFR 423.293 · Collection of monthly beneficiary premium.
- 42 CFR 423.294 · Failure to collect and incorrect collections of premiums and cost sharing.
- 42 CFR 423.301 · Scope.
- 42 CFR 423.308 · Definitions and terminology.
- 42 CFR 423.315 · General payment provisions.
- 42 CFR 423.322 · Requirement for disclosure of information.
- 42 CFR 423.325 · PDE submission timeliness requirements.
- 42 CFR 423.329 · Determination of payments.
- 42 CFR 423.336 · Risk-sharing arrangements.
- 42 CFR 423.343 · Retroactive adjustments and reconciliations.
- 42 CFR 423.346 · Reopening.
- 42 CFR 423.350 · Payment appeals.
- 42 CFR 423.352 · CMS-identified overpayments associated with payment data submitted by Part D sponsors.
- 42 CFR 423.360 · Reporting and returning of overpayments.
- 42 CFR 423.401 · General requirements for PDP sponsors.
- 42 CFR 423.410 · Waiver of certain requirements to expand choice.
- 42 CFR 423.415 · Temporary waivers for entities seeking to offer a prescription drug plan in more than one State in a region.
- 42 CFR 423.420 · Solvency standards for non-licensed entities.
- 42 CFR 423.425 · Licensure does not substitute for or constitute certification.
- 42 CFR 423.440 · Prohibition of State imposition of premium taxes; relation to State laws.
- 42 CFR 423.452 · Scope.
- 42 CFR 423.454 · Definitions.
- 42 CFR 423.458 · Application of Part D rules to certain Part D plans on and after January 1, 2006.
- 42 CFR 423.462 · Medicare secondary payer procedures.
- 42 CFR 423.464 · Coordination of benefits with other providers of prescription drug coverage.
- 42 CFR 423.466 · Timeframes for coordination of benefits and claims adjustments.
- 42 CFR 423.500 · Scope.
- 42 CFR 423.501 · Definitions
- 42 CFR 423.502 · Application requirements.
- 42 CFR 423.503 · Evaluation and determination procedures.
- 42 CFR 423.504 · General provisions.
- 42 CFR 423.505 · Contract provisions.
- 42 CFR 423.506 · Effective date and term of contract.
- 42 CFR 423.507 · Nonrenewal of contract.
- 42 CFR 423.508 · Modification or termination of contract by mutual consent.
- 42 CFR 423.509 · Termination of contract by CMS.
- 42 CFR 423.510 · Termination of contract by the Part D sponsor.
- 42 CFR 423.512 · Minimum enrollment requirements.
- 42 CFR 423.514 · Validation of Part D reporting requirements.
- 42 CFR 423.516 · Prohibition of midyear implementation of significant new regulatory requirements.
- 42 CFR 423.520 · Prompt payment by Part D sponsors.
- 42 CFR 423.521 · Final settlement process and payment.
- 42 CFR 423.522 · Requesting an appeal of the final settlement amount.
- 42 CFR 423.530 · Plan crosswalks.