StacksVerified U.S. regulatory reference

45 CFR §162.1301

Verified against eCFR.gov as of June 20, 2026View official text on eCFR.gov ↗
The referral certification and authorization transaction is any of the following transmissions:
  1. (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.
  2. (b)A request from a health care provider to a health plan to obtain authorization for referring an individual to another health care provider.
  3. (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.