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

Pursuant to 42 CFR 423.568(e) and (f), if a Part D plan denies drug coverage it must give the enrollee written notice of the adverse coverage determination. The form and content of the written denial notice must comport with specific requirements, including a description of the appeals process.

The latest form for Notice of Denial of Medicare Prescription Drug Coverage (CMS-10146) expires 2023-06-30 and can be found here.