# Medicare Program: Changes to the Medicare Claims Appeal Procedures
> **Centers for Medicare and Medicaid Services** · Interim final rule with comment period. · Published 2005-03-08 · Effective 2005-05-01 · 70 FR 11420
## Document
- **Document number:** 05-4062
- **Category:** medicare
- **Sub-agency:** Centers for Medicare and Medicaid Services
- **Federal Register citation:** 70 FR 11420
- **CFR reference:** 42 CFR 401
- **Publication date:** 2005-03-08
- **Effective date:** 2005-05-01
- **HHS docket:** CMS-4064-IFC
## Abstract

Medicare beneficiaries and, under certain circumstances, providers and suppliers of health care services, can appeal adverse determinations regarding claims for benefits under Medicare Part A and Part B under sections 1869 and 1879 of the Social Security Act (the Act). Section 521 of the Medicare, Medicaid, and SCHIP Benefits Act of 2000 (BIPA) amended section 1869 of the Act to provide for significant changes to the Medicare claims appeal procedures. This interim final rule responds to comments on the November 15, 2002 proposed rule regarding changes to these appeal procedures, establishes the implementing regulations, and explains how the new procedures will be implemented. It also sets forth provisions that are needed to implement the new statutory requirements enacted in Title IX of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA).

## Source
- [Federal Register document](https://www.federalregister.gov/documents/2005/03/08/05-4062/medicare-program-changes-to-the-medicare-claims-appeal-procedures)
---
*AI Analytics · CC0 1.0*