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HHS/CMS RIN: 0938-AT62 Publication ID: Fall 2018 
Title: Changes to the Medicare Claims, Medicare Advantage Organization Determination, and Medicare Prescription Drug Coverage Determination Appeals Procedures (CMS-4174-F) 

This final rule streamlines the claims appeals process and reduce associated burden on providers, beneficiaries, and appeals adjudicators. The rule also includes technical changes to correct cross references, inconsistent definitions, and other errors in appeals regulations.

Agency: Department of Health and Human Services(HHS)  Priority: Other Significant 
RIN Status: Previously published in the Unified Agenda Agenda Stage of Rulemaking: Proposed Rule Stage 
Major: No  Unfunded Mandates: No 
EO 13771 Designation: Deregulatory 
CFR Citation: 42 CFR 405    42 CFR 422    42 CFR 423   
Legal Authority: 42 U.S.C. 1395   
Legal Deadline:
Action Source Description Date
Final  Statutory  MMA sec. 902. MMA sec. 902 requires Medicare final rules publish within three years of a proposed or interim final rule. Rule may publish before the three-year deadline.  10/02/2021 
Action Date FR Cite
NPRM  10/02/2018  83 FR 49513   
NPRM Comment Period End  12/03/2018 
Final Action  10/00/2021 
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:
Joella Roland
Social Science Research Analyst
Department of Health and Human Services
Centers for Medicare & Medicaid Services
Center for Medicare, MS: C2-12-16, 7500 Security Boulevard,
Baltimore, MD 21244
Phone:410 786-7638