Updated on: June 22, 2012

CMS to Conduct Town Hall Meeting on Appeals

Original story posted on: October 6, 2009

dennisjones(October 6, 2009) --- The Centers for Medicare & Medicaid Services (CMS) has announced that it will hold what it describes as a "town hall meeting" conference call on Thursday, November 5, on appeals of Medicare payment denials under Section 935 of the Medicare Modernization Act.

CMS also reported that, in the coming weeks, it will issue an official meeting notice and other details on the call, scheduled for 1-3:30 p.m. Eastern Time.

Contributing editor Dennis Jones, Director of Compliance Services for CBIZ KA Consulting, said these changes in the Medicare appeal process should be applicable to RAC appeals as well.

Amendments to Section 935 of the Medicare Modernization Act (MMA) specifically allows providers 41 days to appeal a first level appeal and 60 days to submit a second level appeal before the contractor can begin recoupment.  The amendments also stipulate that CMS is liable to pay interest on accounts overturned in the providers favor above the QIC (second level of appeal.)

Section 935 established a new option for health care providers appealing a Medicare denial, which postpones the recoupment of denied funds when certain new criteria are met. Changes to Section 935 of the MMA can be found in the Federal Register for Wednesday, September 16, 2009.

To pre-register for the call, email medicareoverpayments@cms.hhs.gov

For more RAC updates, visit racmonitor.com.


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