tci Medicare Compliance & Reimbursement - 2005 Issue 13

APPEALS: New Complex Procedures Appeals Rule May Make Physicians Dizzy

Decide in advance what kind of representation to offer.Appealing claims next year could become simpler and quicker in some ways - and harder in others.The Centers For Medicare and Medicaid Services published an interim final rule in the March 8 Federal Register spelling out how the agency will carry out all appeals changes in the Medicare Modernization Act and earlier laws. For instance, the new regulation says all second-level appeals for Part A and Part B will go to Qualified Independent Contractors (QICs) instead of fiscal intermediaries or carriers.Also, the rule will move the Administrative Law...

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