ABA Makes Recommendations to Proposed Medicare Appeals Rules

On July 5, 2016, CMS proposed amendments to the Medicare appeals process to address the backlog of current matters.  On August 29, 2016, the Health Law Section of the American Bar Association submitted comments to the Department of Health and Human Services relating to the proposed rule issued by the Centers for Medicare & Medicaid Services (“CMS”).
The proposed rules present numerous changes for providers, including some increased procedural difficulties relating to Medicare appeals.  The Health Law Section’s comments address, among other things, CMS’s proposals relating to whether certain final decisions are precedential, requirements for the amount in controversy, and requirements to consolidate proceedings related to the same issues.
Although these rules have not been finalized, it is imperative that health care providers and their business personnel continue to monitor these amendments, as it could have long-term effects on how and when a provider can file an appeal to Medicare.
For access to the Health Law Section’s comments, please visit: