US · guidance
CMS Pub. 100-08, ch. 3, § 3.7.4
Tracking Appeals
This section applies to MACs.
The MACs shall track and evaluate the results of appeals. It is not an efficient use of
medical review resources to deny claims that are routinely reversed upon appeal. When
such outcomes are identified, MACs shall take steps to understand why hearing or
appeals officers viewed the case differently from them, and discuss appropriate changes
in policy, procedure, outreach or review strategies with the regional office.
History
(Rev. 377, Issued: 05-27-11, Effective: 06-28-11, Implementation: 06-28-11)
Provenance
- Source
- cms.gov
- Retrieved
- 2026-08-25
- Edition
- iom-2026-08-25
- Content hash
7e1f9f52ae12b1081b3ecdb4563e1bd321355f0ed01b019e3d5219659de48a3c
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