38 CFR §17.120
May 23, 2020 5:50 pmTo the extent allowable, payment or reimbursement of the expenses of emergency treatment, not previously authorized, in a private or... View more
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29 CFR §2560.503-1(f)(2)(iii)(B)
May 23, 2020 5:43 pm(B) Post-service claims. In the case of a post-service claim, the plan administrator shall notify the claimant, in accordance with... View more
29 CFR §2590.715-2719(A)(b)(1-2)
May 23, 2020 4:48 pm(1) If a group health plan, or a health insurance issuer offering group health insurance coverage, provides any benefits with... View more
42 CFR §422.504(i)(1)
May 23, 2020 4:33 pm(i) MA organization relationship with first tier, downstream, and related entities. (1) Notwithstanding any relationship(s) that the MA organization may... View more
45 CFR §164.530 (c)
May 23, 2020 4:26 pm(1) Standard: Safeguards. A covered entity must have in place appropriate administrative, technical, and physical safeguards to protect the privacy... View more
42 CFR § 422.520(b)(1-2)
May 23, 2020 4:20 pm(1) Contracts between MA organizations and providers and suppliers. Contracts or other written agreements between MA organization and providers must... View more
42 CFR § 422.216(a)(3-4)
May 23, 2020 4:19 pm(3) Noncontract providers. The organization pays for services of noncontract providers in accordance with Sec. 422.100(b)(2). (4) Service furnished by... View more
42 CFR § 424.44(a)(1)
May 23, 2020 4:18 pmExcept as provided in paragraphs (b) and (e) of this section, for services furnished on or after January 1, 2010,... View more
42 CFR § 422.520
May 23, 2020 4:17 pm(a) Contract between CMS and the MA organization. (1) The contract between CMS and the MA organization must provide that... View more
42 CFR § 422.113(c)(2-3)
May 23, 2020 4:16 pm(2) The MA organization – (i) Is financially responsible (consistent with Sec. 422.214) for post-stabilization care services obtained within or... View more