Background

This transmittal amends chapter I-3-0 of the Hearings, Appeals and Litigation Law (HALLEX) manual by adding new section I-3-0-50 to provide information about the functions of the Medicare Part D Subsidy Appeals Unit (SAU) within the Office of Appellate Operations.

Explanation of Content and Changes

Section I-3-0-50 is organized as follows:

I-3-0-50 – We added a new section titled “Subsidy Appeals Unit and Appeal of Medicare Part D Subsidies.”

I-3-0-50 A – We added a subsection titled “General” that briefly explains the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA) and how it impacts the Social Security Act. We also set forth the role of the SAU in processing Medicare Part D appeals under the MMA.

I-3-0-50 B – We added a subsection titled “Appeal of Medicare Part D Subsidy Determination” that references the procedures in the Program Operations Manual System for processing Medicare Part D appeals.

Date: November 20, 2014