CMS has developed standardized notices and forms for use by plans, providers and enrollees as described below:Ī plan must issue a written notice to an enrollee, an enrollee's representative, or an enrollee's physician when it denies a request for payment or services. Standardized Notices and FormsĪ CMS Form number and Office of Management and Budget (OMB) approval number, which must appear on the notice, identify OMB-approved, standardized notices and forms.
Medicare health plans must meet the notification requirements for grievances, organization determinations, and appeals processing under the Medicare Advantage regulations found at 42 CFR 422, Subpart M.ĭetails on the applicable notices and forms are available below (including English and Spanish versions of the standardized notices and forms).
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