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CMS Proposes Appeals Process For Medicare Coverage Decisions

September 30, 2002 CMS Proposes Appeals Process For Medicare Coverage Decisions The Centers for Medicare & Medicaid Services (CMS) proposed a rule on August 22, 2002 that would establish a process for beneficiaries to appeal local or national Medicare coverage determinations. The proposed rule provides for independent review of these coverage policies. Under the proposal, appeals of local coverage determinations (LCDs) would be reviewed initially by an administrative law judge (ALJ). Appeals of national coverage determinations (NCDs) and of ALJ decisions on LCDs would be reviewed by the Health and Human Services Departmental Appeals Board. The boardÂ’s decisions could . . .

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