An Applicant or Member, or his or her designee, may seek Review
of a Plan decision. An Applicant or Member may be assisted by his or her
designee. Prescription Advantage will not provide review of any determination
made by a Medicare Part D Plan, and members of those plans must seek review
through those plans. Review consists of the following:
(1)
Customer
Service. The Plan shall maintain a customer service center
accessible toll-free by telephone (including TTY services) to assist Applicants
and Members to resolve any issue regarding the Plan. Said customer service
center shall comply with applicable federal and state law regarding
communication accessibility. Contacting Customer Service is not a required step
in seeking review of a Plan decision.
(2)
Reconsideration.
(a) An Applicant or Member, or his or her
designee, may request Reconsideration of a decision made by the Plan to deny or
terminate enrollment, the Plan's determination of a Member's Gross Annual
Household Income, or a decision by the Plan to deny or limit Covered Benefits.
A request for Reconsideration is the first step in the review process. Such
requests must be made in writing to the Plan.
(b) When an Applicant or Member, or his or
her designee, requests Reconsideration of a decision made by the Plan to deny
enrollment in the Plan pursuant to
651 CMR
15.06(6), or to terminate
enrollment in the Plan pursuant to
651 CMR 15.13, such
request must be made in writing and be received by the Plan within 15 Business
Days after the Applicant's or Member's receipt of such decisions rendered by
the Plan.
(c) Upon receipt of an
Applicant's or a Member's request for Reconsideration pursuant to 651 CMR
15.15(2)(a) or (b), a designated Plan representative shall review the
Applicant's or Member's enrollment file and attempt to resolve any outstanding
issues.
(d) The designated Plan
representative shall make a determination regarding an Applicant's or Member's
request for Reconsideration according to applicable statutes, regulations
and/or Plan policies.
(e) Within 15
Business Days after receiving a request for Reconsideration, the Plan shall
mail to the Applicant or Member, or his or her designee, a written notice
setting forth the Reconsideration determination, including the regulatory
and/or legal citations and policy basis supporting the determination and a
Member's right to an Administrative Review, if applicable.
(3)
Administrative
Review.
(a)
Overview.
1. A
Member, an Applicant, or his or her designee, may seek an Administrative Review
of an adverse Reconsideration determination. Such determinations include, but
are not limited to:
a. a denial of a Member's
request to obtain a Non-preferred Drug at the Copayment level of a Preferred
Drug;
b. a denial of a Member's
request to add to the Plan Formulary a Prescription Drug excluded from the Plan
Formulary;
c. a denial of a
Member's request to gain access to a Prescription Drug excluded from the Plan
Formulary at Plan Formulary rates.
2. A Member, an Applicant, or his or her
designee, may seek an Administrative Review only after pursuing Reconsideration
pursuant to 651 CMR 15.15(2).
3. To
preserve the right to an Administrative Review, a Member or Applicant, or his
or her designee, must respond to the Plan in writing within 15 Business Days
after the Plan's written notification of its Reconsideration finding is
received by the Member.
4. The
Administrative Review shall be conducted by an Administrative Review Officer.
An Administrative Review Officer shall:
a.
have no prior involvement in any matter related to the Member's or Applicant's
issue under Administrative Review; and
b. have no direct or indirect financial
interest, personal involvement or bias in any matter related to the Member's or
Applicant's issue under Administrative Review.
(b)
Administrative Review
Process.
1. Unless a Member or
Applicant requests that a determination be made on the written record as
submitted, the Administrative Review Officer shall schedule an Administrative
Review meeting. The Member or Applicant, or his or her designee, may attend the
Administrative Review meeting in person or by telephone. The Member or
Applicant, or his or her designee, may present any oral or written information
to support his or her request. The Plan shall also be permitted to appear at
the meeting in person or by telephone and present any oral and written
information in support of its decision.
2. An Administrative Review meeting
ordinarily will be scheduled no later than 30 Business Days after receipt of a
request for an Administrative Review.
3.
Information.
a. The Plan and Members or Applicants must
submit to the Administrative Review Officer all materials supporting their
position no later than the conclusion of the scheduled Administrative
Review.
b. In the case of a request
for Administrative Review according to 651 CMR 15.15(3)(a) l.a., such
information must include, but not be limited to:
i. written certification issued by the
Member's physician that the Non-preferred Drug is medically necessary and that
there is no therapeutically equivalent Preferred Drug or Generic Drug available
to the Member on the Plan Formulary; and,
ii. documentation satisfactory to the
Administrative Review Officer exhibiting that the Co-payment for the
Non-preferred Drug would create a financial hardship to the Member.
c. In the case of a request for
Administrative Review according to 651 CMR 15.15(3)(a) l.b. or c, such
information must include, but not be limited to:
i. a written certification issued by the
Member's physician that the Prescription Drug excluded from the Plan Formulary
is medically necessary and that there is no therapeutically equivalent
Prescription Drug available to the Member on the Plan Formulary; and,
ii. documentation satisfactory to the
Administrative Review Officer exhibiting that payment for such drug would
create a financial hardship to the Member.
d. The Administrative Review Officer may, in
his or her discretion, find that additional information is required prior to
rendering a determination, including but not limited to written and verbal
information. In such cases, the Administrative Review Officer shall inform the
Plan and/or the Member or Applicant, or his or her designee, that they have no
more than ten Business Days to submit applicable written information to the
Administrative Review Officer. The Administrative Review Officer shall forward
such additional information to the non-submitting party and allow five Business
Days for that party to respond.
e.
Members or Applicants who fail to comply with the information requirements of
651 CMR 15.15(3)(b)3. in a timely manner may be subject to an adverse
determination.
4.
Determination.
a.
The Administrative Review Officer shall examine the information provided during
the Administrative Review process and render a final written determination.
Said determination shall be made in accordance with applicable statutes,
regulations, and policies governing the Plan. The written determination shall
set forth the legal, regulatory and/or policy basis for such determination, and
the action, if any, to be taken by the Plan.
b. The Administrative Review Officer shall
mail the written determination, to the Member or Applicant, or his or her
designee, and the Plan within 20 Business Days of the receipt of the last
submitted information from the Member or Applicant or the Plan.