Monthly Intermediary Part A and Part B Appeals Report (Form

90 – Monthly Intermediary Part A and Part B Appeals Report (Form CMS-2591) (Rev.12894; 10-17-24; Effective:11-01-24; Implementation:11-01-24) At the end of each month, prepare and transmit to CMS a report summarizing activity on Part A reconsiderations, Part A Administrative Law Judge (ALJ) hearings, Part B reviews, and Part B hearings during the month. Complete a separate report for each office assigned a separate intermediary number. Form CMS-2591 is subject to the Paperwork Reduction Act and requires approval by the Office of Management and Budget (OMB). OMB approval has been requested.