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<classification authority="sudocs">GA 1.13:GAO-03-841</classification>
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 <subject>Claims processing</subject>
 <subject>Health care programs</subject>
 <subject>Insurance claims</subject>
 <subject>Interagency relations</subject>
 <subject>Medical expense claims</subject>
 <subject>Medical information systems</subject>
 <subject>Noncompliance</subject>
 <subject>Decision making</subject>
 <subject>Managed health care</subject>
 <subject>Program coordination</subject>
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 <title>Medicare Appeals: Disparity between Requirements and Responsible Agencies&apos; Capabilities</title>
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<abstract>Appellants 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&apos;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 consistent with	 
BIPA&apos;s requirements and to identify any barriers to meeting the  
law&apos;s requirements.</abstract>
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<subject>
 <topic>Claims processing</topic>
 <topic>Health care programs</topic>
 <topic>Insurance claims</topic>
 <topic>Interagency relations</topic>
 <topic>Medical expense claims</topic>
 <topic>Medical information systems</topic>
 <topic>Noncompliance</topic>
 <topic>Decision making</topic>
 <topic>Managed health care</topic>
 <topic>Program coordination</topic>
 <topic>Timeliness</topic>
 <topic>Medicare Program</topic>
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  <title>United States Statutes at Large</title>
  <partNumber>Volume 114 Page 2763</partNumber>
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 <identifier type="Statute citation">114 Stat. 2763</identifier>
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  <title>Code of Federal Regulations</title>
  <partNumber>Title 20 Part 422.210</partNumber>
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 <identifier type="CFR citation">20 CFR Part  422.210</identifier>
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