Podcast Center
Video Center
Webcasts
Resource Center
Events
By 
May 10, 2019 at 07:17 PM
Medicare program managers are trying to clean up Medicare claims and drug coverage determination appeals rules.
Officials at the Centers for Medicare and Medicaid Services (CMS), an arm of the U.S. Department of Health and Human Services, published a batch of new final appeal program regulations this week in the Federal Register.
The new rules may affect clients who want the original Medicare Part A hospitalization benefits program to cover an operation it has not normally covered, or a Medicare Part D plan to cover a drug the plan does not think it ought to cover.
(Related: Oklahoma Jury Awards $26 Million in Health Insurance Case)
Many of the updates deal with highly technical issues, such as exactly what happens when a patient without a legal representative wants a video teleconference hearing, or an in-person hearing.
One of the somewhat less technical updates deals with the rules for signatures.
Medicare officials have decided to stop asking for signatures on appeal requests for Medicare A hospitalization or Medicare Part B outpatient and physician services appeals, or for Medicare Part D drug plan coverage determination appeals.
