Medicare Appeals/Prescription Drug Appeals Rules
On December 9, HHS published a final rule that will implement the procedures that HHS will follow at the Administrative Law Judge and Medicare Appeals Council levels in deciding appeals brought by individuals who have enrolled in the Medicare prescription drug benefit program. In addition, the regulation will implement the reopening procedures that will be followed at all levels of appeal. HHS also published a separate final rule regarding changes to the Medicare claims appeal procedures. The rule allows Medicare beneficiaries and, under certain circumstances, providers and suppliers of health care services, to appeal certain adverse determinations regarding Medicare Part A and Part B claims. Both rules are effective January 8, 2010.
