United States Government Publishing Office publisher pbl distributor dst United States Government Accountability Office author aut Government Organization text government publication eng GAOREPORTS Legislative Agency Publications gao legislative 2010-08-12 U.S. Government Printing Office 2004-10-04 monographic deposited born digital 47 p. GA 1.13:GAO-05-45 https://www.govinfo.gov/app/details/GAOREPORTS-GAO-05-45 P0b002ee18038816d f:d0545 DGPO 2010-08-12 2011-03-23 GAOREPORTS-GAO-05-45 machine generated eng fdlp REPORT GAOREPORTS-GAO-05-45 GAO-05-45 Health care programs Claims adjudicators Claims processing Insurance claims Medical expense claims Administrative law judges Appeals Medicare Program Other Written Product A12893 The Medicare appeals process has been the subject of widespread concern in recent years because of the time it takes to resolve appeals of denied claims. Two federal agencies play a role in deciding appeals--the Department of Health and Human Services (HHS) and the Social Security Administration (SSA). Currently, neither agency manages and oversees the entire multilevel process. In the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA), Congress mandated that SSA transfer its responsibility for adjudicating Medicare appeals to HHS between July 1, 2005, and October 1, 2005. In addition, it directed the two agencies to develop a transfer plan addressing 13 specific elements related to the transfer. GAO's objective was to determine whether the plan is sufficient to ensure a smooth and timely transition. https://www.govinfo.gov/content/pkg/GAOREPORTS-GAO-05-45/html/GAOREPORTS-GAO-05-45.htm https://www.govinfo.gov/content/pkg/GAOREPORTS-GAO-05-45/pdf/GAOREPORTS-GAO-05-45.pdf GAO-05-45 https://www.govinfo.gov/app/details/GAOREPORTS-GAO-05-45 Other Written Product GAO-05-45; Medicare: Incomplete Plan to Transfer Appeals Workload from SSA to HHS Threatens Service to Appellants; Health care programs Claims adjudicators Claims processing Insurance claims Medical expense claims Administrative law judges Appeals Medicare Program Volume 114 Page 2763A-463 114 Stat. 2763A-463 Volume 117 Page 2066 117 Stat. 2066