Appeals process streamlined

A streamlined appeals process is being prepared by the Health Care Financing Administration (HCFA) that would allow Medicare beneficiaries to know the results of an appeal of a health plan decision in a matter of days.

Under current policy, if a Medicare beneficiary appeals an HMO treatment decision, the patient has to wait up to 60 days for the health plan to consider it, and another 60 days for HCFA to review it. A goal of the new policy is to have rulings on urgent care appeals in a few days, and general appeals within a month.

The new rules are expected to be revealed in early 1997.