Good Cause Processes (CMS-10544)

OMB 0938-1271

OMB 0938-1271

Beneficiaries are provided a protection outlined in regulation at 42 CFR 417.460, 422.74, and 423.44 that provides CMS with the ability to reinstate an individual's enrollment into a Medicare Advantage, Part D or cost plan in certain circumstances where the individual's non-payment of plan premiums was due to circumstances that the individual could not reasonably foresee or could not control, such as an unexpected hospitalization. This submission calculates the administrative cost by Medicare Advantage, Part D and cost plans to process such requests on behalf of CMS.

The latest form for Good Cause Processes (CMS-10544) expires 2021-12-31 and can be found here.

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