8.  Can an enrollee get a temporary fill pending an exception?
Only residents of certain long-term care facilities—skilled nursing facilities, nursing facilities, ICF/MRs and inpatient psychiatric hospitals—who have requested an exception are entitled to a temporary fill pending the plan's decision. CMS has, however, stated that plans should give temporary fills to enrollees when the plan fails to adhere to the required timeframes for rendering a request for an exception (see above.). For more information about these temporary fills, see the CMS Long-Term Care Guidance, Sec. IV: Exceptions and Appeals, p. 5.

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