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CMS Adopts Final Regulations Making Major Changes to Provider Reimbursement Appeal Procedures

CMS Adopts Final Regulations Making Major Changes to Provider Reimbursement Appeal Procedures


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Healthcare providers, practitioners, and suppliers have statutory rights to appeal the amount of payment for their services and supplies under the Medicare program. However, the procedures for these appeals are spelled out in various Medicare regulations and through informal program guidance. The Medicare program recently made major changes to the regulations that govern reimbursement appeals by providers. This article reviews these changes and how they affect providers’ appeals.