To: Jamie Wilson

Office of Information and Regulatory Affairs (OIRA)

Office of Management and Budget (OMB)

From: Coretta Edmondson

Medicare Enrollment and Appeals Group (MEAG)

Division of Appeals Policy (DAP)

Date: February 21, 2023

Subject: Non-Substantive Change Request – Spanish Version of the Notice of Denial of Medicare Prescription Drug Coverage (OMB #0938-0976)

This memo requests approval of a non-substantive change to the approved information collection, Spanish Version of the Notice of Denial of Medicare Prescription Drug Coverage (OMB #-938-0976).

Background

OMB is currently reviewing a revision of a currently approved information collection request for the Medicare Enrollment and Appeals Group. Part D plan sponsors are required to issue the Notice of Denial of Medicare Prescription Drug Coverage notice when a request for a prescription drug or payment is denied, in whole or in part. The written notice must include a statement, in understandable language, the reasons for the denial and a description of the appeals process.

MEAG did not submit a Spanish version of the notice when the original package was sent to initiate the PRA process. The change to the Spanish version is non-substantive in nature and does not affect the burden estimates, but are necessary for clarity for Part D plan sponsors who issue this notice.

Overview of Requested Change

Add Spanish version of the Notice of Denial of Medicare Prescription Drug Coverage that will include updated standardized nondiscriminatory language.