The Part D Reopenings Process and the Part D Appeals Process
Guidance for Part D Sponsors providing the “Explanation of the Reopenings Process and the Appeals Process for 2006 Part D Payment Reconciliation.” This is operational guidance on the reopenings and appeals processes, which are mutually exclusive processes. Generally, a request for reopening is filed when a sponsor believes there is a data submission issue, and appeals are filed when a sponsor does not believe applied its payment methodology correctly.
Issued by: Centers for Medicare & Medicaid Services (CMS)
Issue Date: May 08, 2008
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.