decisionhealth Newsletters, Answer Books - 2006 Issue 3 (March)
Program_Memos / 2001 / AB-01-44
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Article Overview
This article is a Medicare program memorandum from HCFA/DHHS addressing contractor hearing officer obligations in relation to local and regional medical review policies. It is relevant to Medicare intermediaries, carriers, compliance staff, and coding or appeals professionals who need to understand the administrative guidance, affected manual references, and timing of the instruction. The memo also identifies the related HCFA manual sections and the federal regulation cited as authority.
Why This Topic Matters
It clarifies how a specific category of Medicare adjudication personnel is expected to treat contractor-issued medical review policies, and it ties that guidance to cited manual provisions and a federal regulation. Understanding this memo can help readers track policy sources, implementation timing, and the administrative framework governing claim review appeals.
Article Sections
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Program Memorandum / Transmittal Information
Identifies the issuing agency, transmittal identifier, change request, and the date of the memorandum.
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Subject: Binding Contractor Hearing Officers to Local and Regional Medical Review Policies (L/RMRP)
States the policy topic and describes the scope of the memorandum’s administrative guidance for Medicare contractor hearing officers.
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Guidance and References
Summarizes the memorandum’s relationship to Medicare manual provisions, the governing regulation, and the effective and implementation dates.
What You Will Learn
- What administrative topic the memorandum addresses
- Which Medicare manuals are referenced as affected
- Which federal regulation is cited as authority
- The memorandum’s effective and implementation timing
- Who the guidance is intended to inform
Who Should Read This
- Medicare intermediaries
- Medicare carriers
- Hearing officers
- Compliance staff
- Medical review and appeals professionals
Codes Discussed
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