This section provides specific information of particular importance to beneficiaries receiving Part D drug benefits through a Part D plan.  Included below are links to CMS' post-regulatory guidance applicable to the Part D grievance, coverage determination (including exceptions), and appeals processes.

Downloads
Chapter 18 of the Prescription Drug Benefit Manual [pdf, 384kb] Physician Fact Sheet [pdf, 78kb] How to File a Complaint, Coverage Determination, or an Appeal [pdf, 434kb] Flow chart: Medicare Part D Appeals Process [pdf, 28kb]
Related Links Inside CMS
CMS guidance released through the Health Plan Management System (HPMS)
Related Links Outside CMS
Part D QIC Manual [pdf, 408kb]

Page Last Modified: 09/15/2009 9:20:51 AM
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