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CMS Proposes Medicare Appeals Process Revisions

A new proposed rule would revise Medicare payment and coverage determination appeals procedures at the administrative law judge (ALJ) level for Medicare beneficiaries.

According to the Centers for Medicare & Medicaid Services (CMS) proposed rule, attorney adjudicators may hear appeals in lieu of ALJs. This and other changes are intended to reduce a backlog of Medicare payment and coverage determination appeals, the agency said.

Comments on the proposed rule are due to CMS by 5 pm ET on Aug. 29.

Contact Director of Policy Erin O’Malley at eomalley@essentialhospitals.org or 202.585.0127 with questions.

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About the Author

Rachel Schwartz is a policy associate at America's Essential Hospitals.