US Laws - Affordable Health Care Act (HR3950F)
TITLE III--IMPROVING THE QUALITY AND EFFICIENCY OF HEALTH CARE
Subtitle D--Medicare Part D Improvements for Prescription Drug Plans and MA-PD Plans

SEC. 3312. UNIFORM EXCEPTIONS AND APPEALS PROCESS FOR PRESCRIPTION DRUG PLANS AND MA-PD PLANS. (5457)(1-click HTML)

(a) In General- Section 1860D-4(b)(3) of the Social Security Act (42 U.S.C. 1395w-104(b)(3)) is amended by adding at the end the following new subparagraph: (5458)

"(H) USE OF SINGLE, UNIFORM EXCEPTIONS AND APPEALS PROCESS- Notwithstanding any other provision of this part, each PDP sponsor of a prescription drug plan shall-- (5459)

"(i) use a single, uniform exceptions and appeals process (including, to the extent the Secretary determines feasible, a single, uniform model form for use under such process) with respect to the determination of prescription drug coverage for an enrollee under the plan; and (5460)

"(ii) provide instant access to such process by enrollees through a toll-free telephone number and an Internet website.". (5461)

(b) Effective Date- The amendment made by subsection (a) shall apply to exceptions and appeals on or after January 1, 2012. (5462)

  

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