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HHS/CMS RIN: 0938-AL67 Publication ID: Spring 2004 
Title: Revisions to the Medicare Appeals Process (CMS-4004-FC) 
Abstract: This final rule with comment period addresses one discrete aspect of the November 15, 2002, proposed rule, "Changes to the Medicare Claims Appeal Procedures" (67 FR 69312). As required by section 1869(b)(1)(F) of the Social Security Act, this rule establishes expedited determination and reconsideration procedures for beneficiaries who are informed by a provider that Medicare coverage of their services is about to end. This rule implements section 937 of the Medicare Modernization Act which requires a process for correction of minor errors and omissions without pursing the appeals process. 
Agency: Department of Health and Human Services(HHS)  Priority: Other Significant 
RIN Status: Previously published in the Unified Agenda Agenda Stage of Rulemaking: Final Rule Stage 
Major: No  Unfunded Mandates: No 
CFR Citation: 42 CFR 405   
Legal Authority: Sec 521 of BIPA   
Legal Deadline:
Action Source Description Date
NPRM  Statutory  Statutory effective date October 1, 2002.  10/01/2002 
Timetable:
Action Date FR Cite
NPRM  11/15/2002  67 FR 69312   
Final Action  05/00/2005    
Regulatory Flexibility Analysis Required: No  Government Levels Affected: Undetermined 
Small Entities Affected: No  Federalism: No 
Included in the Regulatory Plan: Yes 
Agency Contact:
Janet Miller
Health Insurance Specialist
Department of Health and Human Services
Centers for Medicare & Medicaid Services
N2-14-26, S1-06-04, 7500 Security Boulevard,
Baltimore, MD 21244
Phone:410 786-1588