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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.

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Federal Law

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

08/30/2023 42 CFR 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

08/30/2023 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

08/30/2023 42 CFR 422.111

Disclosure requirements

Network Adequacy-Med. Adv., Termination-Med. Adv.
Federal Law

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

08/30/2023 42 CFR 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

08/30/2023 42 CFR 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

08/30/2023 42 CFR 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

08/30/2023 42 CFR 422.112

Access to services

Network Adequacy-Med. Adv.