Medicare Program; Changes to the Medicare Claims and Medicare Prescription Drug Coverage Determination Appeals Procedures
medicare · Centers for Medicare and Medicaid Services · Rule · Published 2019-05-07 · Effective 2019-07-08 · 84 FR 19855
Document
Document number
2019-09114
Federal Register citation
84 FR 19855
CFR reference
42 CFR 405
Type
Rule
Action
Final rule.
Category
medicare
Sub-agency
Centers for Medicare and Medicaid Services
Publication date
2019-05-07
Effective date
2019-07-08
HHS docket
CMS-4174-F
Abstract
This final rule revises the regulations setting forth the appeals process that Medicare beneficiaries, providers, and suppliers must follow in order to appeal adverse determinations regarding claims for benefits under Medicare Part A and Part B or determinations for prescription drug coverage under Part D. These changes help to streamline the appeals process and reduce administrative burden on providers, suppliers, beneficiaries, and appeal adjudicators. These revisions, which include technical corrections, also help to ensure the regulations are clearly arranged and written to give stakeholders a better understanding of the appeals process.