42 C.F.R. §422.112 - Access to services
| Cite as | 42 C.F.R. §422.112 |
-
- This document is available in original version only for vLex customers
View this document and try vLex for 7 days - TRY VLEX
- This document is available in original version only for vLex customers
11 cases
-
Roberts v. United Healthcare Servs., Inc., B266393
...Medicare Advantage plans (42 U.S.C. § 1395w–21(h) ; 42 C.F.R. §§ 422.2260 –422.2276 ) as well as the adequacy of each plan's network (42 C.F.R. § 422.112 ), and because the Medicare Act provides that the “standards [applied by the Center] shall supersede any State law or regulation (other t......
-
Martin v. Pacificare of Cal., G041732.
...required PacifiCare to continuously monitor Bright's compliance with PacifiCare's standards for timely access to medical care. (See 42 C.F.R. § 422.112(a)(6)(i) (2011).) But the Martins do not point to any evidence showing PacifiCare failed to properly monitor Bright, nor do they provide an......
-
Martin v. Pacificare of Cal., G041732.
...required PacifiCare to continuously monitor Bright's compliance with PacifiCare's standards for timely access to medical care. (See 42 C.F.R. § 422.112(a)(6)(i) (2011).) But the Martins do not point to any evidence showing PacifiCare failed to properly monitor Bright, nor do they provide an......
-
Yarick v. Pacificare of California, F057032.
...and its participating medical providers are contractually bound to provide adequate access to covered medical services. (See, e.g., 42 C.F.R. § 422.112(a)(1) (2008).) Service providers are required to provide medically necessary care in a competent manner. (See id., § 422.112(a)(6)(i) (2008......
Request a trial to view additional results
10 firm's commentaries
-
Health Plan Responsibility to Pay for Hospital Inpatient Care When Members Await Placement at Post-Acute Facilities
...Federal regulations also have standards for Medicare Advantage plans, with standards for network adequacy that can be found at 42 C.F.R. § 422.112. Many States have similar laws and regulations imposing coordination of care and network adequacy requirements on health plans. For example, Cal......
-
Strategizing to Operationalize the Medicare Advantage and Part D Final Rule
...that the MAO can “coordinate all benefits administered by plan” for prescription drugs among Medicare Parts A, B and D under the new 42 C.F.R. § 422.112(b)(7). Part D Plan Sponsors and their vendors will need to plan for distribution of the new Part D Annual Notices of Changes, which must b......
-
CMS Issues CY2024 Proposed Rule for Medicare Advantage Organizations and Part D Sponsors
...historically underserved, marginalized, and adversely affected by persistent poverty and inequality. These changes include: Amending 42 C.F.R. 422.112(a)(8) to require MAOs to ensure that services are provided in a culturally competent manner and to promote equitable access to all enrollees......
-
CMS Issues CY2024 Proposed Rule for Medicare Advantage Organizations and Part D Sponsors
...historically underserved, marginalized, and adversely affected by persistent poverty and inequality. These changes include: Amending 42 C.F.R. 422.112(a)(8) to require MAOs to ensure that services are provided in a culturally competent manner and to promote equitable access to all enrollees......
Request a trial to view additional results