Streamlining Part D Appeals Process Act This bill allows a Medicare beneficiary to directly appeal a pharmacy's refusal to fill a prescription as a coverage determination under the Medicare prescription drug benefit. Currently, if a pharmacy refuses to fill a prescription, the pharmacy provides the beneficiary with a notice explaining how to contact the beneficiary's prescription drug plan (PDP); the beneficiary must then obtain a written coverage determination (i.e., a decision denying coverage) from the PDP before initiating the appeals process.
Administrative law and regulatory proceduresAdministrative remediesDepartment of Health and Human ServicesDepartment of LaborDepartment of the TreasuryEmployee benefits and pensionsFederal preemptionFinancial services and investmentsGovernment information and archivesIncome tax creditsMedicarePrescription drugsSecuritiesSmall businessTax administration and collection, taxpayers
Streamlining Part D Appeals Process Act
USA116th CongressS-1861| Senate
| Updated: 6/13/2019
Streamlining Part D Appeals Process Act This bill allows a Medicare beneficiary to directly appeal a pharmacy's refusal to fill a prescription as a coverage determination under the Medicare prescription drug benefit. Currently, if a pharmacy refuses to fill a prescription, the pharmacy provides the beneficiary with a notice explaining how to contact the beneficiary's prescription drug plan (PDP); the beneficiary must then obtain a written coverage determination (i.e., a decision denying coverage) from the PDP before initiating the appeals process.
Administrative law and regulatory proceduresAdministrative remediesDepartment of Health and Human ServicesDepartment of LaborDepartment of the TreasuryEmployee benefits and pensionsFederal preemptionFinancial services and investmentsGovernment information and archivesIncome tax creditsMedicarePrescription drugsSecuritiesSmall businessTax administration and collection, taxpayers