CMS Extends Timeline for Publishing Claim Appeal Procedures Final Rule

The Centers for Medicare & Medicaid Services (CMS) recently published a Notice in the Federal Register extending the time line for publishing the final rule for Medicare claims appeal procedures until March 1, 2009.  According to the Notice, the extended time line for publishing the final rule means that the March 8, 2005 interim final rule will remain in effect through March 1, 2009 (unless the final rule is published and becomes effective before March 1, 2009).

Medicare beneficiaries and, under certain circumstances, Medicare providers and suppliers, can appeal adverse determinations regarding claims for benefits under Medicare Parts A and B.  Section 521 of the Medicare, Medicaid and SCHIP Benefits Improvement and Protection Act of 2000 (BIPA) revised the Medicare claims appeal procedures and resulted in a November 15, 2002 proposed rule.  According to CMS, the March 8, 2005 interim final rule implements the BIPA provisions and other changes to the Medicare claim appeals procedures following the enactment of the Medicare Prescription Drug, Improvement and Modernization Act of 2003.