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Who has the final say on whether a Medicare claim will be paid or not?

a. Medicare Appeals Council
b. Administrative Law Judge
c. Federal District Court
d. Present of the United States

1 Answer

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Final answer:

The Medicare Appeals Council has the final administrative say on the payment of a Medicare claim, with the Federal District Court being the first judicial step for further appeal. The U.S. Supreme Court could theoretically be involved in significant legal matters related to a claim. The legislative checks over the judiciary include the Senate's role in approving judges, the power of Congress to rewrite laws, and Congress's control over judicial funding.

Step-by-step explanation:

The final say on whether a Medicare claim will be paid or not typically resides with the Medicare Appeals Council as the last administrative step in the appeals process. If a claimant disagrees with the Council's decision, they can take the case to court, beginning with the Federal District Court. However, in some cases, the decision can be further appealed up to the U.S. Supreme Court, which is the highest court in the United States and has the ultimate authority in interpreting the constitutionality of federal laws and regulations. Thus, in the context of Medicare claims, the Supreme Court could theoretically become involved if there is a significant legal issue at stake that pertains to constitutional rights or federal law. It should be noted, though, that regular claim disputes are unlikely to reach the Supreme Court. The President of the United States does not have a direct role in the adjudication of individual Medicare claims.

When considering the checks and balances system, which is a check that the legislative branch has over the courts? The answer is d. all of the above, meaning:

  • Senate approval is required for the appointment of justices and federal judges.
  • Congress may rewrite laws that courts have declared unconstitutional.
  • Congress has the power to withhold funding necessary to implement court decisions.

As for the public healthcare system that primarily insures people over sixty-five, the answer is Medicare.

User John Henckel
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