Expanded OMHA Settlement Conference Pilot Program
The HHS Office of Medicare Hearings and Appeals (OMHA) has announced an expansion of its Settlement Conference Facilitation pilot’s eligibility criteria to include pending appeals for previously denied Part B claims. As previously reported elsewhere, the original pilot program was designed to bring appellants and CMS together to discuss a potential mutually-agreeable resolution to claims appealed to an Administrative Law Judge (ALJ), the third level of Medicare appeals, now hopelessly backlogged for years.
OMHA plans to expand the pilot in two phases, which actually adds a third phase to the pilot. Phase II, already opened October 1, 2015, will expand the settlement conference facilitation eligibility requirements for Part B appeals. Phase III, which is expected to open in 2016, will expand the pilot to include certain Part A appeals. OMHA will conduct an Open Door Teleconference on October 15, 2015, to answer questions from the appellant community related to the pilot; the teleconference registration deadline has passed, but is also available via Appeal Academy, live and via recording, a few hours after the webinar.
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