Click on the links below to view articles, manuals, reports and more relating to Medicare Part D Exceptions and Appeals.

• Medicare Prescription Drug Benefit Manual
Here you will find a link to the CMS Medicare Prescription Drug Manual which contains chapters on enrollment, marketing, exceptions and appeals, formulary requirements and more...
• Prior Authorization Requirements PDF document — 76 KB
June 14, 2007. CMS memo clarifies that plans "must provide current and prospective enrollees (or their physician or authorized representative) with information regarding specific prior authorization ...
• Part D QIC - Reconsideration Procedures Manual PDF document — 214 KB
June 2006. Maximum manual for reconsideration procedures...
• FAQs related to model Part D Coverage Determination Request forms, supporting statements from physicians and processing timeframes for exceptions and prior authorizations PDF document — 44 KB
May 31, 2006. CMS memo answering FAQs related to exceptions and appeals ...
• Model Coverage Determination Denial Notice Microsoft Word Document — 42 KB
CMS' model of the notice plan's must send when denying a coverage determination request...
• Pharmacy Denial Notice Microsoft Word Document — 36 KB
Plans should be requiring all pharmacies to either post or hand out this notice...