Medicare Appeals Process:

Part B Changes Appear to Be Fulfilling Their Purpose

HRD-90-57: Published: Jul 16, 1990. Publicly Released: Jul 16, 1990.

Additional Materials:

Contact:

Office of Public Affairs
(202) 512-4800
youngc1@gao.gov

Pursuant to a congressional request, GAO provided information on changes in claim volume and outcomes at the carrier level following changes in the Medicare Part B appeals process.

GAO found that: (1) in 1988, the Health Care Financing Administration (HCFA) required disputed Part B cases over $500 to go through a carrier hearing before appeal to an administrative law judge; (2) from January 1987 through March 1989, most cases reviewed in hearings involved physicians; (3) the proportion of cases heard by telephone or in person decreased from 29 to 6 percent; (4) the percentage of carrier hearing decisions resulting in payments to claimants decreased after the introduction of mandatory hearings; and (5) the proportion of cases appealed to administrative law judges increased from 11 to 13 percent.

Jan 21, 2021

Jan 14, 2021

Jan 4, 2021

Dec 22, 2020

Dec 16, 2020

Dec 14, 2020

Dec 10, 2020

Looking for more? Browse all our products here