Federal Laws

Find out what rights you and your patients have under current federal statutes and regulations, such as the Employee Retirement Income Security Act and the Medicare Advantage program.

Federal Law

Title 42-Chapter IV-Subchapter B-Part 422-Subpart C. Benefits and Beneficiary Protections

11/14/2024 42 CFR Section 422.116

Network adequacy

Network Adequacy-Med. Adv.
Ama Policy

Ban on Medicare Advantage “No Cause” Network Terminations H-285.902

10/14/2019
Directories-Med. Adv., Network Adequacy-Med. Adv., Termination-Med. Adv.
Federal Law

Title 42-Chapter 7-Subchapter XVIII-Part C. Medicare+Choice Program

11/21/2024 42 USC Section 1395w-22

Benefits and beneficiary protections

Anti-gag clause-Med. Adv., Directories-Med. Adv., Liability-insurer shifting to physician-Med. Adv., Med. Adv.-Med. Nec. Appeals-Deadlines, Med. Adv.-Med. Nec. Decisions-Deadlines, Network Adequacy-Med. Adv., Prohibited financial incentives-Med. Adv., Risk-Physicians Taking-Med. Adv.
Federal Law

Title 42-Chapter IV-Subchapter B-Part 422-Subpart C. Benefits and Beneficiary Protections

11/18/2024 42 CFR Section 422.111

Disclosure requirements

Network Adequacy-Med. Adv.
Federal Law

Title 42-Chapter IV-Subchapter B-Part 422-Subpart C. Benefits and Beneficiary Protections

11/14/2024 42 CFR Section 422.114

Access to services under an MA private fee-for-service plan

Network Adequacy-Med. Adv.
Federal Law

Title 42-Chapter IV-Subchapter B-Part 417-Subpart Subpart J. Qualifying Conditions for Medicare Contracts

11/18/2024 42 CFR Section 417.416

Qualifying condition: Furnishing of services

Network Adequacy-Med. Adv.
Federal Law

Title 42-Chapter IV-Subchapter B-Part 417-Subpart Subpart J. Qualifying Conditions for Medicare Contracts

11/18/2024 42 CFR Section 417.414

Qualifying condition: Range of services

Network Adequacy-Med. Adv.
Federal Law

Title 42-Chapter IV-Subchapter B-Part 422-Subpart C. Benefits and Beneficiary Protections

11/18/2024 42 CFR Section 422.112

Access to services

Network Adequacy-Med. Adv.