{"abstract":"This proposed rule would revise the regulations setting forth the appeals process that Medicare beneficiaries, providers, and suppliers must follow in order to appeal adverse determinations regarding claims for benefits under Medicare Part A and Part B or determinations for prescription drug coverage under Part D. These changes would help streamline the appeals process and reduce administrative burden on providers, suppliers, beneficiaries, and appeal adjudicators. These revisions, which include technical corrections, would also help to ensure the regulations are clearly arranged and written to give stakeholders a better understanding of the appeals process.","action":"Proposed rule.","agencies":[{"raw_name":"DEPARTMENT OF HEALTH AND HUMAN SERVICES","name":"Health and Human Services Department","id":221,"url":"https://www.federalregister.gov/agencies/health-and-human-services-department","json_url":"https://www.federalregister.gov/api/v1/agencies/221","parent_id":null,"slug":"health-and-human-services-department"},{"raw_name":"Centers for Medicare & Medicaid Services","name":"Centers for Medicare & Medicaid Services","id":45,"url":"https://www.federalregister.gov/agencies/centers-for-medicare-medicaid-services","json_url":"https://www.federalregister.gov/api/v1/agencies/45","parent_id":221,"slug":"centers-for-medicare-medicaid-services"}],"body_html_url":"https://www.federalregister.gov/documents/full_text/html/2018/10/02/2018-21223.html","cfr_references":[{"chapter":null,"citation_url":null,"part":405,"title":42},{"chapter":null,"citation_url":null,"part":423,"title":42}],"citation":"83 FR 49513","comment_url":null,"comments_close_on":"2018-12-03","correction_of":null,"corrections":[],"dates":"To be assured consideration, comments must be received at one of the addresses provided below, no later than 5 p.m. on December 3, 2018.","disposition_notes":null,"docket_ids":["CMS-4174-P"],"dockets":[{"supporting_documents":[],"agency_name":"CMS","documents":[{"comment_count":15,"comment_start_date":"2018-10-02","updated_at":"2023-03-01T02:57:18.601-05:00","comment_url":"https://www.regulations.gov/commenton/CMS-2018-0110-0001","allow_late_comments":null,"id":"CMS-2018-0110-0001","comment_end_date":"2018-12-04","regulations_dot_gov_open_for_comment":false}],"supporting_documents_count":0,"id":"CMS-2018-0110","title":"Changes to the Medicare Claims and Medicare Prescription Drug Coverage Determination Appeals Procedures (CMS-4174-P) "}],"document_number":"2018-21223","effective_on":null,"end_page":49529,"executive_order_notes":null,"executive_order_number":null,"full_text_xml_url":"https://www.federalregister.gov/documents/full_text/xml/2018/10/02/2018-21223.xml","html_url":"https://www.federalregister.gov/documents/2018/10/02/2018-21223/medicare-program-changes-to-the-medicare-claims-and-medicare-prescription-drug-coverage","images":{},"images_metadata":{},"json_url":"https://www.federalregister.gov/api/v1/documents/2018-21223?publication_date=2018-10-02","mods_url":"https://www.govinfo.gov/metadata/granule/FR-2018-10-02/2018-21223/mods.xml","not_received_for_publication":null,"page_length":17,"page_views":{"count":2105,"last_updated":"2026-08-23 20:15:04 -0400"},"pdf_url":"https://www.govinfo.gov/content/pkg/FR-2018-10-02/pdf/2018-21223.pdf","presidential_document_number":null,"proclamation_number":null,"public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2018-21223.pdf?1538147717","publication_date":"2018-10-02","raw_text_url":"https://www.federalregister.gov/documents/full_text/text/2018/10/02/2018-21223.txt","regulation_id_number_info":{"0938-AT27":{"issue":"201804","html_url":"https://www.federalregister.gov/regulations/0938-AT27/hospital-inpatient-prospective-payment-system-for-acute-care-hospitals-and-the-long-term-care-hospit","title":"Hospital Inpatient Prospective Payment System for Acute Care Hospitals and the Long-Term Care Hospital Prospective Payment System and FY 2019 Rates (CMS-1694-P)","xml_url":"http://www.reginfo.gov/public/do/eAgendaViewRule?pubId=201804&RIN=0938-AT27&operation=OPERATION_EXPORT_XML","priority_category":"Economically Significant"}},"regulation_id_numbers":["0938-AT27"],"regulations_dot_gov_info":{"supporting_documents":[],"regulatory_plan":{"html_url":"https://www.federalregister.gov/regulations/0938-AT27/hospital-inpatient-prospective-payment-system-for-acute-care-hospitals-and-the-long-term-care-hospit","title":"Hospital Inpatient Prospective Payment System for Acute Care Hospitals and the Long-Term Care Hospital Prospective Payment System and FY 2019 Rates (CMS-1694-P)"},"comments_count":15,"agency_id":"CMS","comments_url":"https://www.regulations.gov/docketBrowser?rpp=50&so=DESC&sb=postedDate&po=0&dct=PS&D=CMS-2018-0110","supporting_documents_count":0,"docket_id":"CMS-2018-0110","document_id":"CMS-2018-0110-0001","regulation_id_number":"0938-AT27","title":"Changes to the Medicare Claims and Medicare Prescription Drug Coverage Determination Appeals Procedures (CMS-4174-P) ","checked_regulationsdotgov_at":"2023-03-01T07:57:17Z"},"regulations_dot_gov_url":null,"significant":true,"signing_date":null,"start_page":49513,"subtype":null,"title":"Medicare Program: Changes to the Medicare Claims and Medicare Prescription Drug Coverage Determination Appeals Procedures","toc_doc":"Changes to the Medicare Claims and Medicare Prescription Drug Coverage Determination Appeals Procedures","toc_subject":"Medicare Program:","topics":["Administrative practice and procedure","Diseases","Emergency medical services","Health facilities","Health maintenance organizations (HMO)","Health professions","Medical devices","Medicare","Penalties","Privacy","Reporting and recordkeeping requirements","Rural areas","X-rays"],"type":"Proposed Rule","volume":83}