View Rule

View EO 12866 Meetings Printer-Friendly Version     Download RIN Data in XML

HHS/OS RIN: 0991-AC02 Publication ID: Fall 2016 
Title: Medicare Program; Changes to the Medicare Claims and Entitlement, Medicare Advantage Organization Determination, and Medicare Prescription Drug Coverage Determination Appeals Procedures 
Abstract:

This proposed rule would revise the procedures that the Department of Health and Human Services would follow at the Administrative Law Judge level for appeals of payment and coverage determinations for items and services furnished to Medicare beneficiaries, enrollees in Medicare Advantage and other Medicare competitive health plans, and enrollees in Medicare prescription drug plans, as well as appeals of Medicare beneficiary enrollment and entitlement determinations, and certain Medicare premium appeals.  In addition, this proposed rule would revise procedures that the Department of Health and Human Services would follow at the Centers for Medicare & Medicaid Services (CMS) and the Medicare Appeals Council (Council) levels of appeal for certain matters affecting the Administrative Law Judge level.

 
Agency: Department of Health and Human Services(HHS)  Priority: Other Significant 
RIN Status: Previously published in the Unified Agenda Agenda Stage of Rulemaking: Long-Term Actions 
Major: No  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
Timetable:
Action Date FR Cite
NPRM  07/05/2016  81 FR 43789   
NPRM Comment Period End  09/05/2016 
Final Action  11/00/2017 
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