HCFA drastically cuts appeal time
HCFA drastically cuts appeal time
A new rule by the Baltimore-based Health Care Financing Administration (HCFA) could cut the appeal process time HMOs currently have from 120 days to six.
The ruling is presently open to comments and expected to go into effect in August. Denials of care and discharge dates appealed by beneficiaries would have to be addressed in writing within three days under the proposed rule. Patients can then ask for a reconsideration, and HMOs have another three days to render a final decision.
Exceptions to the rule include decisions that could jeopardize life, health, or the ability to regain maximum function’ and appeals by physicians.
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