| Currently approved version |
Non-substantive change package version |
Type of Change |
Reason for Change |
Burden Change |
| Notice - Section entitled "Why did we deny your request?" states, in part: "You should share a copy of this decision with your prescriber so you and your prescriber can discuss next steps. If your prescriber requested coverage on your behalf, we have sent a copy of this decision to your prescriber." |
Notice - Section entitled "Why did we deny your request?" Modifying this text slightly to: "You should share a copy of this decision with your prescriber so you and your prescriber can discuss next steps. If your prescriber requested coverage on your behalf, we have shared this decision with your prescriber." |
Nonsubstantive |
Modified for succinctness/clarity. It has come to our attention that plans may misinterpret this to mean that a hard copy must be provided to the prescriber in all circumstances (which isn't the intent). |
No |
| Notice - Includes the following text re: alternative formats: "CMS does not discriminate in its programs and activities. To request this publication in an alternative format, please call 1-800-MEDICARE or email: [email protected]" |
Notice - Includes the following text re: alternative formats: "CMS does not discriminate in its programs and activities: To request this form in an accessible format (e.g., Braille, Large Print, Audio CD) contact your Medicare Drug Plan. If you need assistance contacting your plan, call: 1-800-MEDICARE."
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Nonsubstantive |
Include recently approved alternate format language that is more appropriate for Part D plan enrollees. This language had not been approved for use in beneficiary notices when previous package went through PRA. |
No; providing alternate formats is an existing obligation of Part D plans. |
| Title of Instructions - "Notice of Denial of Medicare Prescription Drug Coverage" |
Title of Instructions - "Notice of Denial of Medicare Part D Prescription Drug Coverage" |
Nonsubstantive |
For consistency with title of notice; omission of "Part D" was an oversight in previous package. |
No |
| Notice/Instructions - In the section related to situations where the plan may have determined that the requested drug is or may be covered under Part A or B, the notice and instructions state that the plan must include the optional language. |
Notice/Instructions - We're modifying the text to delete "the plan must" include the optional language. Instruction in notice to explain the conditions of approval in a readable and understandable format--parenthesis changed to brackets { } per instructions. |
Nonsubstantive |
Modified for clarity so that plans don't misinterpret the notice/instructions to mean that the optional text has to be included in all circumstances (to be included only if the plan has made a determination that the drug is/may be covered under Medicare A or B). |
No |
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