CMS Finally Finalizes Medicare Claims Appeal Procedures
December 18, 2009
By: Paul W. Kim and Mark A. Stanley *
The appeal of Part A and B claims denied by Medicare contractors, including the RACs, is subject to a process that was revised by an interim final rule with comment period issued on March 8, 2005, pursuant to a proposal published on November 15, 2002. On December 9, 2009, CMS finally addressed the 26 comments that it received in 2005 and finalized the rule in a 43-page Federal Register publication [PDF]. Other than technical revisions (e.g., "days" vs. "calendar days" and "final" vs. "final and binding"), CMS did not make any substantive change that affects appeal rights, deadlines, format, etc.
This is one final rule that you can place on the back burner.
* Mark A. Stanley is a former member of Ober|Kaler's Health Law Group.
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