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GAO-03-841, Medicare Appeals: Disparity between Requirements and Responsible Agencies’ Capabilities

September 2003 Medicare Appeals: Disparity between Requirements and Responsible Agencies' Capabilities Applicants and others have been concerned about the length of time it takes for a decision on the appeal of a denied Medicare claim. In December 2000, the Medicare, Medicaid, and SCHIP Benefits Improvement and Protection Act of 2000 (BIPA), required, among other things, shorter decision time frames. BIPA's provisions related to Medicare appeals were to be applied to claims denied after October 1, 2002, but many of the changes have not yet been implemented. GAO was asked to evaluate whether the current Medicare appeals process is operating . . .

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