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US · guidance

CMS Pub. 100-16, ch. mc86c16b, § 20.2.10.1.3

Other Considerations

activein force · 2026-08-25 – presentas-observed

Each D-SNP must, upon request from CMS, provide documentation demonstrating its compliance

with 42 CFR 422.562(a)(5).

The obligation to provide assistance under 42 CFR 422.562(a)(5)(i) does not create an obligation for

a D-SNP to represent an enrollee in a Medicaid appeal. Further, it does not include a requirement to

resolve the coverage issue.

History

(Rev. 131; Issued: 11-22-24; Effective: 11-22-24; Implementation: 11-22-24)

Provenance

Source
cms.gov
Retrieved
2026-08-25
Edition
iom-2026-08-25
Content hash
3a9000ed14ea4eee46eaa4a4711615b154e9e320d0808106d95721ff37761934
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