45 CFR 162.1301
§ 162.1301 Referral certification and authorization transaction.
United States · 45 CFR — Public Welfare · Status: effective
Cite this
- Citation
- 45 CFR 162.1301, § 162.1301 Referral certification and authorization transaction, United States, version 1 as recorded 2026-07-09, yourstate.us, https://yourstate.us/provision/218030
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Full text
The referral certification and authorization transaction is any of the following transmissions:
(a) A request from a health care provider to a health plan for the review of health care to obtain an authorization for the health care.
(b) A request from a health care provider to a health plan to obtain authorization for referring an individual to another health care provider.
(c) A response from a health plan to a health care provider to a request described in paragraph (a) or paragraph (b) of this section.
Legislative history
This is a federal regulation, adopted through agency rulemaking under the Administrative Procedure Act — not enacted by a recorded vote of Congress.