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Federal programs / Medicare Part D (drug coverage)

Medicare Part D (drug coverage)

A coverage determination first (including exceptions, which need the prescriber's supporting statement), then a redetermination by the plan, then the Independent Review Entity.

FormUse it toDeadlineIssued by
Redetermination request (model form and process)Ask the plan to reconsider a coverage determination65 days from the date on the notice (42 CFR 423.582)CMS
Prescription drug appeals and grievances (overview)Every Part D appeal level and model noticeSee the noticeCMS
CMS-1696, Appointment of RepresentativeLet someone act for youWith the appealCMS

Where it goes

The plan's appeals address or fax on the denial notice; the prescriber can request an expedited exception by phone.

The rule

42 CFR Part 423, Subpart M; exceptions under 42 CFR 423.578. Links verified 2026-09-15; the notice you received controls over anything here.

Want the appeal itself written to the criteria, with the rule cited? Apellica's generator is free; a reviewer can also read the denial first.