45 CFR § 800.501 - General requirements.

---
identifier: "/us/cfr/t45/s800.501"
source: "ecfr"
legal_status: "authoritative_unofficial"
title: "45 CFR § 800.501 - General requirements."
title_number: 45
title_name: "Public Welfare"
section_number: "800.501"
section_name: "General requirements."
chapter_name: "OFFICE OF PERSONNEL MANAGEMENT"
part_number: "800"
part_name: "MULTI-STATE PLAN PROGRAM"
positive_law: false
currency: "2026-03-24"
last_updated: "2026-03-24"
format_version: "1.1.0"
generator: "[email protected]"
authority: "Sec. 1334 of Pub. L. 111-148, 124 Stat. 119; Pub. L. 111-152, 124 Stat. 1029 (42 U.S.C. 18054)."
regulatory_source: "80 FR 9655, Feb. 24, 2015; 80 FR 16577, Mar. 30, 2015, unless otherwise noted."
cfr_part: "800"
---


# 800.501 General requirements.

(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.