45 CFR 800.501
§ 800.501 General requirements.
United States · 45 CFR — Public Welfare · Status: effective
Cite this
- Citation
- 45 CFR 800.501, § 800.501 General requirements, United States, version 1 as recorded 2026-07-09, yourstate.us, https://yourstate.us/provision/220025
- Permanent ID
ys:prov:220025@1- SHA-256
a910c71628261c1593ea750cd83f1536968b93f7b2d18cb2c4959c11a9df7ef7
The hash is SHA-256 of this version's text, with every run of whitespace collapsed to a single space and the ends trimmed. The ID always leads back here, and checking it says whether the text you cited is still the current version.
Full text
(a) Definitions. For purposes of this subpart:
(1) Adverse benefit determination has the meaning given that term in 45 CFR 147.136(a)(2)(i).
(2) Claim means a request for:
(i) Payment of a health-related bill; or
(ii) Provision of a health-related service or supply.
(b) Applicability. This subpart applies to enrollees and to other individuals or entities who are acting on behalf of an enrollee and who have the enrollee's specific written consent to pursue a remedy of an adverse benefit determination.
Legislative history
This is a federal regulation, adopted through agency rulemaking under the Administrative Procedure Act — not enacted by a recorded vote of Congress.