Tag Archives: OMHA

“Finally Friday!” ALJ Training Given by OMHA, CMS and MAC

FRIDAY December 2, 2016: “ALJ Training Given by OMHA, CMS and MAC” or We finally get a peek behind the curtain and… maybe this is how Dorothy felt? Get the Handouts Sponsored by The Health Law Partners and ZirMed THIS … Continue reading

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AHA Offers HHS Solutions to Reduce Medicare Appeals Backlog

The American Hospital Association (AHA) recently advised the Department of Health and Human Services (HHS) to implement three solutions that would significantly reduce the Medicare appeals backlog at the administrative law judge level. Continue reading

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Proposal to reduce Medicare appeals backlog won’t solve problem

In a letter to HHS’ Office of Medicare Hearings and Appeals, the American Hospital Association said HHS’ recent proposal to reduce the Medicare appeals backlog at the administrative law judge level is likely “to do little more than scratch the … Continue reading

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Medicare’s Efforts To Curb Backlog Of Appeals Not Sufficient, GAO Reports

By Susan Jaffe  | June 10, 2016 | Original post at Kaiser Health News Republished by permission. Despite interventions by Medicare officials, the number of appeals from health care providers and patients challenging denied claims continues to spiral, increasing the … Continue reading

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“Finally Friday!” OMHA Settlement Conference Facilitation Program Expansion

FRIDAY October 16, 2015: “OMHA SCF Pilot Expansion“ Got Appeals? Who doesn’t… Make ’em count! Get the Handouts The Office of Medicare Hearings and Appeals just issues an expansion program for their Settlement Conference Facilition Pilot Program. One wonders at what … Continue reading

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OMHA Offers Settlement of Part B Appeals

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, … Continue reading

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CMS Reveals One Surprise at the OMHA Appellant Forum

Some Appeals Receive Some Protection Post-payment denials for anything other than “lack of documentation” are protected from reviews for additional or new reasons for denial, effective August 1, according to Michael Crochunis, Deputy Director for the Medicare Enrollment and Appeals … Continue reading

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U.S. Senate Committee blames providers for appeals backlog

Forget the denials, reduce the appeals The U.S. Senate Finance Committee heard testimony and expressed dismay yesterday about the humongous backlog of appeals at the Office of Medicare Hearings and Appeals (OMHA), now totaling over 870,000 appeals, according to testimony … Continue reading

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CMS Report Reveals 77% of Appealed RAC Denials Are Improper

Figures Show 55% of RAC Denials Are Improper If you read my previous article and then read the CMS Report to Congress for the RAC Program in FY2013, you can find figures that tell the story in the title of … Continue reading

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CMS FY 2013 Recovery Auditing Report to Congress Released

How CMS Continues to Mislead with Statistics CMS posted their report to Congress on recovery auditing in Medicare for FY2013, including many tables, charts and limited explanations, plus a bevy of perhaps accurate but misleading figures and percentages, obviously intended … Continue reading

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