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This section provides specific information of particular importance to beneficiaries receiving Part D drug benefits through a Part D plan. Use the navigation tool on the left side of this page to link to sub-pages with more detailed information on areas such as grievances, coverage determinations and exceptions, appeals under Part D, and other guidance. On March 17, 2008, the Centers for Medicare and Medicaid Services published a proposed rule (CMS-4127-P) that sets forth the procedures the Department of Health and Human Services would follow at the Administrative Law Judge (ALJ) and Medicare Appeals Council (MAC) levels in deciding appeals brought by individuals who have enrolled in the Medicare prescription drug benefit program, and the reopenings procedures that would be followed at all levels of appeal. The regulations largely codify the current appeals processes at the ALJ and MAC levels, and also include modifications of Part 405 provisions to clarify the process, increase efficiency, and take into account the requirements of the Part D program. You can view CMS-4127-P by clicking on the link in the "Downloads" section below, or access it from the Federal Register website using the link in "Related Links Inside CMS" below.
Page Last Modified: 08/19/2008 2:27:35 PM
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