The Office of Medicare Hearings and Appeals (OMHA) has recently published a “Request for Information” regarding the Administrative Law Judge (ALJ) Program for Medicare Claim Appeals. The Request follows a OMHA Appellant Forum where OMHA officials “detailed the ever-increasing appeal backlog along with its initiatives to bring greater efficiencies and productivities into the ALJ appeal process.”
There are nearly 900,000 ALJ level appeals awaiting assignment and processing. Due to the volume of pending appeals, the assignment of appeals to ALJs has been suspended since July 2013. OMHA has has taken steps to improve the appeals process since the backlogged appeals began. NAHC has recommended that CMS “institute a mass settlement option that offers the home health and hospice community a quick and simple process for a compromise settlement based on historical ALJ reversal rates.”
Click here to access the Request for Information.
Click here to read more from NAHC.