42 CFR §423.2536

1. (a)General information. Paragraphs (1) and (3)(B) of section 1860D-4(a) of the Act (relating to dissemination of general information; availability of information on changes in formulary through the internet).
2. (b)Formularies. Subparagraphs (A) and (B) of section 1860D-4(b)(3) of the Act (relating to requirements on development and application of formularies; formulary development) and formulary requirements in §§ 423.120(b) and 423.128(e)(5) and (6).
3. (c)Medicare Prescription Payment Plan. Section 423.137.
4. (d)Cost control and quality improvement requirements. Provisions under subpart D of this part, including requirements about medication therapy management, are waived except for the provisions in § 423.2508(c)(1) through (5).
   1. (1)Section 423.153(b) and (c) for dispensing and point-of-sale safety edits;
   2. (2)Section 423.154 for appropriate dispensing of prescription drugs in long-term care facilities;
   3. (3)Sections 423.159 and 423.160 for electronic prescribing, excepting the requirements pertaining to formulary standards in § 423.160(b)(5);
   4. (4)Section 423.162 for QIO activities; and
   5. (5)Section 423.165 for compliance deemed on the basis of accreditation.
5. (e)Out-of-network access. Section 423.124 Special rules for out-of-network access to Part D drugs at out-of-network pharmacies, except for § 423.124(a)(2), which applies to LI NET.
6. (f)Medicare contract determinations and appeals. Subpart N, except for the provisions that apply to LI NET in § 423.2520(d).
7. (g)Risk-sharing arrangements. Section 423.336(a), (b), and (d).
8. (h)Certification of accuracy of data for price comparison. Section 423.505(k)(6).
9. (i)Part D communication requirements. Portions of subpart V of this part related to Part D communication requirements that are inapplicable to LI NET, including:
   1. (1)Section 423.2265(b)(4), (5), (11), (13), and (16);
   2. (2)Section 423.2265(c);
   3. (3)Section 423.2266(a);
   4. (4)Section 423.2267(e)(3) through (5), (9) through (12), (14) through (17), (25), (29), (33), and (45) through (51); and
   5. (5)Section 423.2274.
10. (j)Medicare Coverage Gap Discount Program. Subpart W of this part.
11. (k)Requirements for a minimum medical loss ratio. Subpart X of this part.
12. (l)Recovery audit contractor Part C appeals process. Subpart Z of this part.