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HHS/OS | RIN: 0991-AC02 | Publication ID: Spring 2017 |
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. |
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Agency: Department of Health and Human Services(HHS) | Priority: Other Significant |
RIN Status: Previously published in the Unified Agenda | Agenda Stage of Rulemaking: Completed 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 |
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Timetable:
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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 |