Part D Coverage Determinations, Appeals and Grievances (CDAG) Audit Process and Universe Request
Guidance for evaluation of Medicare plan’s performance in the three areas related to coverage determinations, appeals, and grievances. The Centers for Medicare & Medicaid Services will perform its audit activities using these instructions (unless otherwise noted).
Issued by: Centers for Medicare & Medicaid Services (CMS)
Issue Date: January 01, 2014
DISCLAIMER: The contents of this database lack the force and effect of law, except as authorized by law (including Medicare Advantage Rate Announcements and Advance Notices) or as specifically incorporated into a contract. The Department may not cite, use, or rely on any guidance that is not posted on the guidance repository, except to establish historical facts.