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|a EBLCP
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|c EBLCP
|d OCLCO
|d OCLCQ
|d REDDC
|d OCLCO
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| 020 |
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|a 9781641059084
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|a 1641059087
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|a (OCoLC)1402813321
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|b .G878 2021
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|a 780
|2 23
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| 049 |
|
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|a UAMI
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| 100 |
1 |
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|a Gustafson, Jessica Lee.
|
| 245 |
1 |
0 |
|a What Are... Medicare Appeals? Second Edition
|h [electronic resource].
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| 260 |
|
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|a La Vergne :
|b American Bar Association,
|c 2022.
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| 300 |
|
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|a 1 online resource (62 p.)
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| 500 |
|
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|a Description based upon print version of record.
|
| 505 |
0 |
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|a Intro -- Title Page -- Copyright Page -- Contents -- Introduction -- About the Authors -- Chapter 1 Medicare Part A and Part B Audits -- A. Comprehensive Error Rate Testing (CERT) Audits -- B. Medicare Administrator Contractor (MAC) Audits -- Targeted Probe and Educate -- Post-payment and Pre-payment Medical Reviews -- C. Supplemental Medical Review Contractor (SMRC) Audits -- D. Recovery Audits -- E. Unified Program Integrity Contractor (UPIC) Audits -- Chapter 2 Overview of the Medicare Part A and Part B Appeals Process -- A. Stage 1: Redetermination -- Recoupment during Redetermination
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| 505 |
8 |
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|a B. Stage 2: Reconsideration -- Recoupment during Reconsideration -- C. Stage 3: ALJ Hearing -- ALJ Backlog and Resolution -- Statistical Sampling Initiative -- Settlement Conference Facilitation Pilot -- D. Stage 4: Medicare Appeals Council (the "Council") Review -- E. Stage 5: Federal District Court Review -- Chapter 3 Legal Challenges to Part A and Part B Audit Determinations -- A. Advocating the Merits -- B. Treating Physician Rule -- HCFA Ruling 93-1 -- C. Waiver of Liability -- D. Provider without Fault -- E. Challenges to Statistical Extrapolations
|
| 505 |
8 |
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|a Medicare Prescription Drug, Improvement and Modernization Act -- Challenges to the Validity of a Statistical Sample -- Resources and Reference Materials -- A. ABA Health Law Section Resources -- B. Government Resources -- C. Statutory, Regulatory (i.e., Code of Federal Regulations ("[CFR]")), and Sub-Regulatory Guidance Citations Related to the Medicare Part A and Part B FFS Appeals Process and Medicare Audits -- D. Statutory, Regulatory, and Sub-Regulatory Guidance Citations Related to the Medicare Part A and Part B FFS Related to Legal Challenges to Medicare Audit Determinations -- Index
|
| 590 |
|
|
|a ProQuest Ebook Central
|b Ebook Central Academic Complete
|
| 650 |
|
0 |
|a Medicare
|x Law and legislation.
|
| 650 |
|
0 |
|a Medicare
|x Claims administration.
|
| 650 |
|
0 |
|a Administrative remedies
|z United States.
|
| 650 |
|
6 |
|a Recours administratifs
|z États-Unis.
|
| 700 |
1 |
|
|a Pendleton, Abby.
|
| 776 |
0 |
8 |
|i Print version:
|a Gustafson, Jessica Lee
|t What Are... Medicare Appeals? Second Edition
|d La Vergne : American Bar Association,c2022
|z 9781641059077
|
| 856 |
4 |
0 |
|u https://ebookcentral.uam.elogim.com/lib/uam-ebooks/detail.action?docID=7293940
|z Texto completo
|
| 938 |
|
|
|a ProQuest Ebook Central
|b EBLB
|n EBL7293940
|
| 994 |
|
|
|a 92
|b IZTAP
|
