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Benefits and Beneficiary Protections | Midpage
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Code of Federal Regulations
Title 42
Chapter IV
Subchapter B
Part 422
Subpart C
Benefits and Beneficiary Protections
422.100
General requirements.
422.101
Requirements relating to basic benefits.
422.102
Supplemental benefits.
422.103
Benefits under an MA MSA plan.
422.104
Special rules on supplemental benefits for MA MSA plans.
422.105
Special rules for self-referral and point of service option.
422.106
Coordination of benefits with employer or union group health plans and Medicaid.
422.107
Requirements for dual eligible special needs plans.
422.108
Medicare secondary payer (MSP) procedures.
422.109
Effect of national coverage determinations (NCDs) and legislative changes in benefits; coverage of clinical trials and A and B device trials.
422.110
Discrimination against beneficiaries prohibited.
422.111
Disclosure requirements.
422.112
Access to services.
422.113
Special rules for ambulance services, emergency and urgently needed services, and maintenance and post-stabilization care services.
422.114
Access to services under an MA private fee-for-service plan.
422.116
Network adequacy.
422.118
Confidentiality and accuracy of enrollee records.
422.119
Access to and exchange of health data and plan information.
422.120
Access to published provider directory information.
422.121
Access to and exchange of health data for providers and payers.
422.122
Prior authorization requirements.
422.125
Resolution of complaints in a Complaints Tracking Module.
422.128
Information on advance directives.
422.132
Protection against liability and loss of benefits.
422.133
Return to home skilled nursing facility.
422.134
Reward and incentive programs.
422.135
Additional telehealth benefits.
422.136
Medicare Advantage (MA) and step therapy for Part B drugs.
422.137
Medicare Advantage Utilization Management Committee.
422.138
Prior authorization.