MES Certification Navigator
EE27

Appeals

CMS-required outcome

Beneficiaries and applicants can submit an appeal against an adverse action via multiple channels (e.g., online, phone, mail, in person) and the status and adjudication of an appeal can easily be accessed by necessary state staff and appellants.

Default metrics
  • Percentage of appeals requested through each modality (mail, online, phone, in person).
  • Number of pending appeals in the reporting period.
Regulatory sources
  • For all states, District of Columbia, and territories:
  • - 42 CFR 431.221

Other Eligibility and Enrollment outcomes