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Preparation for 2017 Star Ratings Quality Assurance Reviews on Part D
Coverage Determinations and Redeterminations

Guidance for: This memo provides an
overview of the responsibilities of Part D sponsors that are selected for quality assurance (QA) review as a result of being identified as potential appeals auto-forward outliers and the new process for submitting the required documentation.

Download the Guidance Document

Final

Issued by: Centers for Medicare & Medicaid Services (CMS)

Issue Date: April 29, 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.