MLN Product (Revised): Medicare Parts A & B Appeals Process

This revised Product comprises Subregulatory Guidance for the Medicare Parts A & B Appeals Process, and its content is based on publically available content within at
https://www.federalregister.gov/documents/2019/05/07/2019-09114/medicare-program-changes-to-the-medicare-claims-and-medicare-prescription-drug-coverage, https://www.ssa.gov/OP_Home/ssact/title18/1879.htm#act-1879-a-2, https://www.ecfr.gov/cgi-bin/text-idx?SID=4c5867a1e8f1505d6ee4d21dcd018953&mc=true&node=pt42.2.405&rgn=div5%20-%20se42.2.405_1910%20-%20se42.2.405_1910#se42.2.405_1910, https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/Downloads/clm104c29pdf.pdf, https://www.ecfr.gov/cgi-bin/text-idx?c=ecfr&SID=934b72c9c14240880948b1590c0844b1&rgn=div5&view=text&node=42:2.0.1.2.5&idno=42#se42.2.405_1972, and https://www.ecfr.gov/cgi-bin/text-idx?SID=b07f3240b817c6c81615e1251e5686fb&mc=true&node=se42.2.405_11028&rgn=div8, https://www.ecfr.gov/cgi-bin/text-idx?c=ecfr&SID=934b72c9c14240880948b1590c0844b1&rgn=div5&view=text&node=42:2.0.1.2.5&idno=42#se42.2.405_11052. CMS policy or operation subject matter experts also reviewed/cleared this product. This Product educates providers about Medicare’s 5 appeal levels in Fee-for-Service (FFS) (original Medicare) Parts A & B. It also describes how providers, physicians, and suppliers apply the appeals process to their services. There are no substantive content updates to this Product. The previous version of this Product is available to the public and currently posted on the CMS website at https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/Downloads/MedicareAppealsProcess.pdf.
This revised product comprises Subregulatory Guidance for Medicare Part A and B appeals and its content is based on publically available content within: https://www.ecfr.gov/current/title-42/chapter-IV/subchapter-B/part-405/subpart-I
CMS policy or operation subject matter experts also reviewed/cleared this product.
This product informs health care providers about Medicare’s 5 appeal levels in Fee-for-Service (FFS) (Original Medicare) Parts A and B and includes resources on related topics. It also describes how providers, physicians, and suppliers apply the appeals process to their services.
No substantive content updates were made to this product.
The current version of this product is available here: https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/Downloads/MedicareAppealsProcess.pdf