MLN006562 – Medicare Parts A & B Appeals Process
This revised Product comprises Subregulatory Guidance for the Medicare Parts A & B Appeals Process booklet, and its content is based on publicly available content within https://www.cms.gov/Medicare/CMS-Forms/CMS-Forms/Downloads/CMS1696.pdf, https://www.ssa.gov/OP_Home/ssact/title18/1879.htm#act-1879-a-2,
https://www.ecfr.gov/current/title-42/chapter-IV/subchapter-B/part-405#405.910,
https://www.cms.gov/Medicare/CMS-Forms/CMS-Forms/Downloads/CMS20031.pdf, and
https://www.cms.gov/Medicare/CMS-Forms/CMS-Forms/downloads/cms20027.pdf. CMS policy or operation subject matter experts also reviewed/cleared this product. This Product educates providers about the requirements of appointing a representative, transfer appeal rights, and the 5 appeal levels. This booklet gives an overview of these actions and details the provider’s responsibilities. This revised product does not contain any substantive changes to the previous version dated August 2022.
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..
Final
Issued by: Centers for Medicare & Medicaid Services (CMS)
Issue Date: January 08, 2024
DISCLAIMER: The contents of this database lack the force and effect of law, except as authorized by law (including Medicare Advantage Rate Announcements and Advance Notices) or as specifically incorporated into a contract. The Department may not cite, use, or rely on any guidance that is not posted on the guidance repository, except to establish historical facts.