Additional Guidance and New Model Notice for Favorable Good Cause
Determinations for Disenrollment Due to Nonpayment of Plan Premiums
Guidance for: The purpose of this memorandum is to provide Medicare Advantage (MA) organizations,
Prescription Drug Plan (PDP)sponsors and §1876 cost organizations additional guidance and a new model notice to convey the plan sponsor’s favorable good cause determination when the individual has already paid the amount required for reinstatement.
Issued by: Centers for Medicare & Medicaid Services (CMS)
Issue Date: May 20, 2016
DISCLAIMER: The contents of this database lack the force and effect of law, except as authorized by law (including Medicare Advantage Rate Announcements and Advance Notices) or as specifically incorporated into a contract. The Department may not cite, use, or rely on any guidance that is not posted on the guidance repository, except to establish historical facts.