(a) Processes. MSP issuers must comply with the internal claims and appeals processes applicable
to group health plans and health insurance issuers under 45 CFR 147.136(b).
(b) Timeframes and notice of determination. An MSP issuer must provide written notice to an enrollee of its determination on
a claim brought under paragraph (a) of this section according to the timeframes and
notification rules under 45 CFR 147.136(b) and (e), including the timeframes for urgent claims. If the MSP issuer denies a claim (or a portion of the claim), the enrollee may appeal
the adverse benefit determination to the MSP issuer in accordance with 45 CFR 147.136(b).
FindLaw Codes may not reflect the most recent version of the law in your jurisdiction. Please verify the status of the code you are researching with the state legislature or via Westlaw before relying on it for your legal needs.
Was this helpful?
Welcome to FindLaw's Cases & Codes
A free source of state and federal court opinions, state laws, and the United States Code. For more information about the legal concepts addressed by these cases and statutes, visit FindLaw's Learn About the Law.