Prescription Drug Benefit Manual:
CMS Guidances

 

Guidances describe the everyday operation of Medicare Prescription Drug Coverage in the following subjects:

Marketing	Quality Improvement and Medication Therapy Management
Enrollment	Fraud, Waste, and Abuse
Creditable Coverage Period Determinations/Late Enrollment Penalty	Coordination of Benefits
Benefits and Beneficiary Protections	Grievances, Coverage Determinations, and Appeals
Formulary	Low-Income Subsidy

---

 

Marketing

Chapter 2 of the Prescription Drug Benefit Manual

Pre-Enrollment Website Guidance

 

Enrollment

Chapter 3 of the Prescription Drug Benefit Manual

 

Creditable Coverage Period Determinations/Late Enrollment Penalty

Chapter 4 of the Prescription Drug Benefit Manual

 

Benefits and Beneficiary Protections

Chapter 5 of the Prescription Drug Benefit Manual

 

Formulary

Chapter 6 of the Prescription Drug Benefit Manual

Summary - Final Formulary Guidance Changes from Draft

 

Quality Improvement and Medication Therapy Management

Chapter 7 of the Prescription Drug Benefit Manual

 

Fraud, Waste, and Abuse

Chapter 9 of the Prescription Drug Benefit Manual

 

Coordination of Benefits

Chapter 14 of the Prescription Drug Benefit Manual

 

Grievances, Coverage Determinations, and Appeals

Chapter 18 of the Prescription Drug Benefit Manual

Summary - Update to Chapter 18

 

Low-Income Subsidy

Guidance to States on the Low-Income Subsidy