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HHS/OS RIN: 0991-AC02 Publication ID: Fall 2015 
Title: 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.

Agency: Department of Health and Human Services(HHS)  Priority: Substantive, Nonsignificant 
RIN Status: Previously published in the Unified Agenda Agenda Stage of Rulemaking: Proposed Rule Stage 
Major: Undetermined  Unfunded Mandates: No 
CFR Citation: 42 CFR 405    42 CFR 422    42 CFR 417    42 CFR 423    42 CFR 478   
Legal Authority: 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   
Legal Deadline:  None
Action Date FR Cite
NPRM  11/00/2015 
NPRM Comment Period End  01/00/2016 
Final Action  03/00/2016 
Final Action Effective  08/00/2016 
Regulatory Flexibility Analysis Required: No  Government Levels Affected: None 
Federalism: No 
Included in the Regulatory Plan: No 
RIN Data Printed in the FR: No 
Agency Contact:
Jason M. Green
Director, OMHA Program Evaluation and Policy Division
Department of Health and Human Services
Office of the Secretary
Suite 1800, 1700 N. Moore Street,
Arlington, VA 22209
Phone:703 235-0124