GroundRules
42 CFR 422.574: Parties to the organization determination.
Where this section sits in the code
- Title 42—Public Health
- CHAPTER IV—CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES
- SUBCHAPTER B—MEDICARE PROGRAM
- PART 422—MEDICARE ADVANTAGE PROGRAM
- Subpart M—Grievances, Organization Determinations and Appeals
The parties to the organization determination are—
(a) The enrollee (including his or her representative);
(b) An assignee of the enrollee (that is, a physician or other provider who has furnished a service to the enrollee and formally agrees to waive any right to payment from the enrollee for that service);
(c) The legal representative of a deceased enrollee's estate; or
(d) Any other provider or entity (other than the MA organization) determined to have an appealable interest in the proceeding.
Collected 2026-08-27T02:26:11Z. Source file · JSON