{"data":{"id":"us/42-cfr-423.1","jurisdiction":"us","citation":"42 CFR 423.1","heading":"Basis and scope.","body":"(a) Basis. (1) This part is based on the indicated provisions of the following sections of the Social Security Act:\n1106. Disclosure of Information in Possession of Agency.\n1128J(d). Reporting and Returning of Overpayments.\n1860D-1. Eligibility, enrollment, and information.\n1860D-2. Prescription drug benefits.\n1860D-3. Access to a choice of qualified prescription drug coverage.\n1860D-4. Beneficiary protections for qualified prescription drug coverage.\n1860D-11. PDP regions; submission of bids; plan approval.\n1860D-12. Requirements for and contracts with prescription drug plan (PDP) sponsors.\n1860D-13. Premiums; late enrollment penalty.\n1860D-14. Premium and cost-sharing subsidies for low-income individuals.\n1860D-14A. Medicare coverage gap discount program.\n1860D-14C. Manufacturer Discount Program.\n1860D-15. Subsidies for Part D eligible individuals for qualified prescription drug coverage.\n1860D-16. Medicare Prescription Drug Account in the Federal Supplementary Medical Insurance Trust Fund.\n1860D-21. Application to Medicare Advantage program and related managed care programs.\n1860D-22. Special rules for Employer-Sponsored Programs\n1860D-23. State pharmaceutical assistance programs.\n1860D-24. Coordination requirements for plans providing prescription drug coverage.\n1860D-31. Medicare prescription drug discount card and transitional assistance program.\n1860D-41. Definitions; treatment of references to provisions in Part C.\n1860D-42. Miscellaneous provisions.\n1860D-43. Condition for coverage of drugs under this part.\n(2) The following specific sections of the Medicare Modernization Act also address the prescription drug benefit program:\nSec. 102 Medicare Advantage conforming amendments.\nSec. 103 Medicaid amendments.\nSec. 104 Medigap.\nSec. 109 Expanding the work of Medicare Quality Improvement Organizations to include Parts C and D.\n(3) Section 1611 of Title 8 of the United States Code regarding individuals who are not lawfully present and ineligible for Federal public benefits.\n(b) Scope. This part establishes standards for beneficiary eligibility, access, benefits, protections, and low-income subsidies in Part D, as well as establishes standards and sets forth requirements, limitations, procedures and payments for organizations participating in the Voluntary Medicare Prescription Drug Program.","path":["Title 42—Public Health","CHAPTER IV—CENTERS FOR MEDICARE \u0026 MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES","SUBCHAPTER B—MEDICARE PROGRAM","PART 423—VOLUNTARY MEDICARE PRESCRIPTION DRUG BENEFIT","Subpart A—General Provisions"],"source_url":"https://www.ecfr.gov/api/versioner/v1/full/2026-08-25/title-42.xml","current_through":"2026-08-25","vintage":"","retrieved_at":"2026-08-27T02:26:11Z","sha256":"44e29944e7d964bb704ca869e0b2a9ddb6e46cfb9b91b3f94652e28426c5679f","source_id":"us-cfr","stale":true,"prev":"us/42-cfr-422.2615","next":"us/42-cfr-423.4"},"notice":"GroundRules: Original legal text. Not legal advice."}