60 Day Crosswalk

EXHIBIT A
Notice of Denial of Medicare Prescription Drug Coverage
CMS-10146
CHANGE CROSSWALK
CURRENTLY
APPROVED
Non-discrimination
language on page 4:
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.

CHANGE TO
NOTICE
You have the right
to get Medicare
information in an
accessible format,
like large print,
Braille, or audio.
You also have the
right to file a
complaint if you feel
you’ve been
discriminated
against. Visit
Medicare.gov/aboutus/accessibilitynondiscriminationnotice, or call 1800- MEDICARE
(1-800633-4227) for more
information. TTY users
can call 1-877-4862048.

EXPLANATION
This is the updated
standardized
nondiscrimination
language required on
CMS forms and
notices.

Page 1 of 1