{"data":{"id":"us/42-cfr-423.580","jurisdiction":"us","citation":"42 CFR 423.580","heading":"Right to a redetermination.","body":"An enrollee who has received a coverage determination (including one that is reopened and revised as described in § 423.1978) or an at-risk determination under a drug management program in accordance with § 423.153(f) may request that it be redetermined under the procedures described in § 423.582, which address requests for a standard redetermination. The prescribing physician or other prescriber (acting on behalf of an enrollee), upon providing notice to the enrollee, may request a standard redetermination under the procedures described in § 423.582. An enrollee or an enrollee's prescribing physician or other prescriber (acting on behalf of an enrollee) may request an expedited redetermination as specified in § 423.584.","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 M—Grievances, Coverage Determinations, Redeterminations, and Reconsiderations"],"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":"2962307c546cb09799184c98aebcc492e31891765c744232957640f3dff5ee49","source_id":"us-cfr","stale":true,"prev":"us/42-cfr-423.578","next":"us/42-cfr-423.582"},"notice":"GroundRules: Original legal text. Not legal advice."}