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CMS Home > Medicare > Medicare Prescription Drug Appeals & Grievances > Guidance

Guidance

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 [zip, 302kb]

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

Medicare Appeals - How to File a Complaint, Coverage Determination, or an Appeal [pdf, 716kb]

Medicare Rights and Protections  [pdf, 780kb]

 

Page Last Modified: 01/06/2012 10:14:45 AM
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