Procedures Manual
Part D QIC Reconsideration Procedures Manual (PDF)
Reconsideration Procedures Manual Log
| Version # |
Effective Date |
Description |
| 1 |
February 2021 |
Creation |
| 2 |
February 2021 |
Style changes to “C2C Contact Information” page |
| 3 |
March 2021 |
Style changes to “C2C Contact Information” page |
| 4 |
June 2021 |
- Updated Section 7.3.4 “Dismissal of a LEP Reconsideration Request” to clarify processing of unsigned requests
- Updated Plan Liaison name after staffing change
- Updated Medical Director name after staffing change
|
| 5 |
January 2022 |
Added Section 6.9.3 “Part D QIC review of plan dismissal appeal requests” to document processing of new appeal type |
| 6 |
February 2023 |
- Updated Section 8.2.2 “Process for Part D Plan requesting a reopening” to clarify processing of Plan reopening requests
- Added Section 8.3.3 “Requesting Missing Information (RFI)” to document process for OMHA RFIs
- Updated section 8.3.5 “OMHA Decisions” to clarify effectuation process and added process for when the QIC did not (or has not yet received notice) of an OMHA Decision but the Plans have.
- Added Section 8.3.6 “OMHA Remands” to document processing of OMHA Remands
- Updated Section 8.4.2 “Referral to the Council for Own Motion Review” to clarify the process for referrals
- Added Section 8.4.3 “Medicare Appeals Council Decisions” to document Council decision effectuations
|
| 7 |
May 2023 |
Updated Plan Liaison name after staffing change |
| 7 |
August 2023 |
Updated address to C2C’s new physical address |
| 8 |
November 2023 |
Updated Program Director and edited grammar for 8.4.2 Referral to the Council for Own Motion Review |
| 9 |
March 2024 |
- Updated Section 3.2.1 “Designation of a key plan contact, phone number, fax number and email” Providing clear instructions for completing the Plan Contact Form
- Updated Section 8.2.2 “Process for Part D plan requesting a reopening” to clarify Reopening Request requirements and instructions
- Updated address to C2C’s new physical address
- Corrected document version value citations within manual
|