Crosswalk (60-day)

60-day Federal Register Crosswalk: High Level Summary of Revisions

The current Coverage Decision Letter expires 11/2025. We have made minor updates to the
letter that are listed below. The Coverage Decision Letter is issued to applicable integrated plan
enrollees when a request for a service or item is denied. The changes will not result in additional
burden.

Section

Change/Reason

Throughout
We updated the term “Part B drug” to “Medicare Part B drug” throughout the document
the document to differentiate it from a Medicaid drug.
Second
paragraph

We changed the term “partially denied” to “partially approved” for consistency with the
Medicare Advantage integrated denial notice.

Section
For the standard appeal timeframe, we clarified the 7-calendar day timeframe only
titled: There applies to a Medicare Part B drug not yet received.
are two kinds
of appeals