Notice of Denial of Medicare Prescription Drug Coverage (CMS-10146 and 10146SP)

Crosswalk for Changes to Notice of Denial of Medicare Prescription Drug Coverage (CMS-10146)

Summary of Changes to CMS-10146
1. General Changes: We have added clarification to the notice in order to make the notice easier
for Part D Plans to use, and for Part D enrollees to understand.

Section on Current CMS-10146

Type of Change

Rationale for Change

Why did we deny your request

Included additional instructions
to discuss the form with your
doctor

This change was added for clarity

Why did we deny your request

Included additional instructions
for language to include for B vs.
D drugs

This change was added for clarity

What If I Don’t Agree With This
Decision

Included instructions on what to
include when requesting an
exception

This change was added for clarity

What Do I include with My
Appeal Request

Included information about
supporting statements

This change was made based on
feedback from advocates

Get Help and More Information

Added additional contact
information

This change was made to include
additional resources for
beneficiaries

Get Help and More Information

Included alternative formats
contact information

This change was made to help
beneficiaries who need to access
the denial notice in alternate
formats.

Summary of Changes to Instructions:
The following changes have been made to the instructions as a result of changes made to the
denial notice, and for the purpose of enhancing the clarity or accuracy of the instructions:



Under the section titled “Why Did We Deny Your Request”, included language clarifying
Utilization Management criteria from seeking an exception.



Under the section titled “Why Did We Deny Your Request”, included language clarifying
B vs. D coverage determination requirements.