Crosswalk

EXHIBIT A

Notice of Denial of Medicare Prescription Drug Coverage CMS-10146
CHANGE CROSSWALK
CURRENTLY
APPROVED

You have the right to appeal. If
you want to appeal, you must
request your appeal within
60 calendar days after the date
of this notice. We can give you
more time if you have a good
reason for missing the deadline.

CHANGE TO NOTICE

EXPLANATION

You have the right to ask us to
review our decision by asking us
for an appeal within 65 calendar
days of the date of this notice. If
you ask for an appeal after 65
days, you must explain why your
appeal is late.

The language was
changed due to a
regulatory change that
will go into effect on
01/01/2025. The
timeframe to file an
appeal with the plan has
been amended in CMS4205-F to allow 65 days
rather than 60 days. This
change was made to
account for the timeframe
it takes for an enrollee or
other appropriate party to
receive the notice.

Based on consumer testing and
CMS Office of Communications
review, several changes were
made to improve clarity and
readability for the person
receiving this notice. These
changes are non-substantive and
are intended to ease use and
utilize more plain language.

Updated language and
formatting to utilize more
research- based ‘plain
language’ and formatting
consistent with current
CMS guidelines. In
response to consumer
testing, we also made
revisions to improve
clarity for the reader.

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