U.S. Code of Federal Regulations

Regulations most recently checked for updates: Aug 27, 2025

All TitlesTitle 42Chapter IVPart 438Subpart F - Subpart F—Grievance and Appeal System
§ 438.400 - Statutory basis, definitions, and applicability.
§ 438.402 - General requirements.
§ 438.404 - Timely and adequate notice of adverse benefit determination.
§ 438.406 - Handling of grievances and appeals.
§ 438.408 - Resolution and notification: Grievances and appeals.
§ 438.410 - Expedited resolution of appeals.
§ 438.414 - Information about the grievance and appeal system to providers and subcontractors.
§ 438.416 - Recordkeeping requirements.
§ 438.420 - Continuation of benefits while the MCO, PIHP, or PAHP appeal and the State fair hearing are pending.
§ 438.424 - Effectuation of reversed appeal resolutions.
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