{"abstract":"This final rule revises 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 help to streamline the appeals process and reduce administrative burden on providers, suppliers, beneficiaries, and appeal adjudicators. These revisions, which include technical corrections, also help to ensure the regulations are clearly arranged and written to give stakeholders a better understanding of the appeals process.","action":"Final 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/2019/05/07/2019-09114.html","cfr_references":[{"chapter":null,"citation_url":null,"part":405,"title":42},{"chapter":null,"citation_url":null,"part":423,"title":42}],"citation":"84 FR 19855","comment_url":null,"comments_close_on":null,"correction_of":null,"corrections":[],"dates":"These regulations are effective on July 8, 2019.","disposition_notes":null,"docket_ids":["CMS-4174-F"],"dockets":[],"document_number":"2019-09114","effective_on":"2019-07-08","end_page":19874,"executive_order_notes":null,"executive_order_number":null,"full_text_xml_url":"https://www.federalregister.gov/documents/full_text/xml/2019/05/07/2019-09114.xml","html_url":"https://www.federalregister.gov/documents/2019/05/07/2019-09114/medicare-program-changes-to-the-medicare-claims-and-medicare-prescription-drug-coverage","images":{},"images_metadata":{},"json_url":"https://www.federalregister.gov/api/v1/documents/2019-09114?publication_date=2019-05-07","mods_url":"https://www.govinfo.gov/metadata/granule/FR-2019-05-07/2019-09114/mods.xml","not_received_for_publication":null,"page_length":20,"page_views":{"count":3833,"last_updated":"2026-07-25 20:15:03 -0400"},"pdf_url":"https://www.govinfo.gov/content/pkg/FR-2019-05-07/pdf/2019-09114.pdf","presidential_document_number":null,"proclamation_number":null,"public_inspection_pdf_url":"https://public-inspection.federalregister.gov/2019-09114.pdf?1556896515","publication_date":"2019-05-07","raw_text_url":"https://www.federalregister.gov/documents/full_text/text/2019/05/07/2019-09114.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":{"checked_regulationsdotgov_at":"2019-05-24T16:51:05Z"},"regulations_dot_gov_url":null,"significant":true,"signing_date":null,"start_page":19855,"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":"Rule","volume":84}