Subpart F—Grievance and Appeal System

Sections

Section numbering in the official eCFR can be non-consecutive. Omitted section numbers are not treated here as reserved unless the source explicitly labels them that way.

• § 438.400
  § 438.400 Statutory basis, definitions, and applicability.
• § 438.402
  § 438.402 General requirements.
• § 438.404
  § 438.404 Timely and adequate notice of adverse benefit determination.
• § 438.406
  § 438.406 Handling of grievances and appeals.
• § 438.408
  § 438.408 Resolution and notification: Grievances and appeals.
• § 438.410
  § 438.410 Expedited resolution of appeals.
• § 438.414
  § 438.414 Information about the grievance and appeal system to providers and subcontractors.
• § 438.416
  § 438.416 Recordkeeping requirements.
• § 438.420
  § 438.420 Continuation of benefits while the MCO, PIHP, or PAHP appeal and the State fair hearing are pending.
• § 438.424
  § 438.424 Effectuation of reversed appeal resolutions.