CENTER
FOR MEDICARE ADVOCACY'S ACTIONS RESULT IN
CMS REQUIRING DURABLE MEDICAL EQUIPMENT CARRIER TO ISSUE PROPER NOTICES
On January 22, 2003, the Center for Medicare Advocacy, Inc., (the Center) requested that the Centers for Medicare & Medicaid Services (CMS) review various policies and practices of the hearing office, Federal Hearings and Appeals Services, Inc., in Plymouth, Pennsylvania. Per a letter dated March 13, 2003, from CMS to the Center, a review was performed and, as a result of that review, the following actions were initiated:
HealthNow, the Durable Medical
Equipment Regional Carrier for Region A, has instructed Federal Hearings and
Appeals Services, Inc. that it is required by Medicare regulations to
provide written notification to all parties of record in the Medicare
appeals it processes. The Hearing Officer implemented that instruction
immediately.
On February 19, 2003, Federal
Hearings and Appeals Services, Inc., removed the language, "This is for
your information. You do not need to do anything as a result of this
letter," from its cover letter used to notify Medicare beneficiaries of
Medicare denials. Additionally, the revised cover letter will now include a
paragraph advising Medicare beneficiaries of options available to them to
obtain help with appeals, including a telephone number (1-800-MEDICARE) to
contact if they have questions.
Lastly, Federal Hearings and Appeals Services, Inc., was instructed to send a letter to approximately 574 Medicare beneficiaries who received a cover letter with confusing language and who still would be eligible to request an appeal (decisions issued between 01/20/03 –02/19/03). This letter will clarify their due process rights and include the "help with an appeal paragraph" that will now be included in all issued cover letters.
© Center for Medicare Advocacy, Inc. 05/05/2008