Laws and Regulations

The menu contains links to useful information for Medicare managed care enrollees and representatives.

CMS Part C Appeals Guidance

• This provides guidance on the appeal provisions set forth at 42 CFR Part 422 Subpart M and 42 CFR Part 423 Subparts M and U. It addresses grievances, coverage/organization determinations and appeals for beneficiaries enrolled in a plan provided by Medicare Part C Health Plans.

CMS Legal References

• This provides specific information of particular importance to plans, providers and beneficiaries receiving Part C benefits through a Medicare Health Plan.

Medicare Managed Care Manual

• This provides internet-only manuals (IOMs), which are a replica of the Centers for Medicare & Medicaid Services (CMS) official record copy.

Medicare Coverage Database

• This provides information related to what is and is not covered by Medicare.

Medicare Home Page

• This provides general information about Medicare.

CMS Home Page

• This provides general information about CMS.