CMS proposes additional Medicare appeals processes聽
The Centers for Medicare & Medicaid Services Dec. 21 issued a to provide additional appeals processes for Medicare beneficiaries in certain circumstances. The proposed rule is the result of a nationwide class action case filed in 2011 and affirmed by the U.S. Court of Appeals for the Second Circuit in January 2022 ordering the Secretary of the Department of Health and Human Services to establish additional appeals processes for Medicare beneficiaries who were admitted as an inpatient but whose status changed to outpatient during their hospital stay. The proposed appeals processes include an expedited appeal for beneficiaries who appeal their hospital status during their stay, a standard appeal for beneficiaries who appeal after discharge from the hospital, and a retrospective appeal for beneficiaries involved in the class action suit.