{"data":{"id":"us/45-cfr-162.1301","jurisdiction":"us","citation":"45 CFR 162.1301","heading":"Referral certification and authorization transaction.","body":"The referral certification and authorization transaction is any of the following transmissions:\n(a) A request from a health care provider to a health plan for the review of health care to obtain an authorization for the health care.\n(b) A request from a health care provider to a health plan to obtain authorization for referring an individual to another health care provider.\n(c) A response from a health plan to a health care provider to a request described in paragraph (a) or paragraph (b) of this section.","path":["Title 45—Public Welfare","SUBTITLE A—Department of Health and Human Services","SUBCHAPTER C—ADMINISTRATIVE DATA STANDARDS AND RELATED REQUIREMENTS","PART 162—ADMINISTRATIVE REQUIREMENTS","Subpart M—Referral Certification and Authorization"],"source_url":"https://www.ecfr.gov/api/versioner/v1/full/2026-08-25/title-45.xml","current_through":"2026-08-25","vintage":"","retrieved_at":"2026-08-27T02:26:21Z","sha256":"ccf6be20f5ef6e8d2bfde14b56dd527937ed29921733392c97cb89c50d1e061d","source_id":"us-cfr","stale":true,"prev":"us/45-cfr-162.1203","next":"us/45-cfr-162.1302"},"notice":"GroundRules: Original legal text. Not legal advice."}