0991-AC02 201510 The Regulatory Plan and the Unified Agenda of Federal Regulatory and Deregulatory Actions 0991 Office of the Secretary OS 0900 Department of Health and Human Services HHS Medicare Program: Changes to the Medicare Claim, Organization Determination, and Coverage Determination Appeals Procedures

This proposed rule would make changes to procedures for Medicare fee-for-service claim appeals, managed care organization determination appeals, and prescription drug plan coverage determination appeals to increase administrative efficiencies and set forth procedures that will help position the administrative appeals process to address the increasing number of appeals in a manner that is responsive to appellants needs for timely determinations on Medicare coverage and payment, while maximizing the efficiencies in administering the appeals programs.

]]> Substantive, Nonsignificant Previously Published in The Unified Agenda Proposed Rule Stage Undetermined No 42 CFR 405 42 CFR 422 42 CFR 417 42 CFR 423 42 CFR 478 42 U.S.C. 1395pp 42 U.S.C. 1395ff 42 U.S.C 1395w-22 42 U.S.C. 1395mm 42 U.S.C. 1395w-104 42 U.S.C. 1320c-a No NPRM 11/00/2015 NPRM Comment Period End 01/00/2016 Final Action 03/00/2016 Final Action Effective 08/00/2016 No None No No No No Jason Green M. Director, OMHA Program Evaluation and Policy Division 0991 Office of the Secretary OS 703 235-0124 Suite 1800, 1700 N. Moore Street, Arlington VA 22209