CMS Issues Guidance for
Appeals Process
CMS has issued guidance for hospitals that are appealing
payment denials by the agency and its contractors. The
guidance becomes effective July 1. Authorized by the
Medicare Modernization Act (MMA), the guidance affects all
Medicare appeals activity, including appeals of medical
necessity review denials by fiscal intermediaries and Medicare
administrative contractors, and appeals of payment denials
by recovery audit contractors. It prevents funds from being
recouped during the first two stages of the five-stage appeals
process.
The guidance document is available at http://tiny.cc/EMH28 |