CHA News Article

Changes Announced for Medicare Appeals Process

Two important changes to the Medicare appeals process, intended to streamline settlement options, were announced last week. First, the Centers for Medicare & Medicaid Services has created a new settlement option for eligible providers and suppliers with a low volume of pending Medicare Part A and B claim appeals. To be eligible, appellants must have fewer than 500 appeals, with a total billed amount of $9,000 or less per appeal, at the third and fourth appeal levels combined. Second, the Office of Medicare Hearings and Appeals will expand its current Settlement Conference Facilitation Program to provide certain providers an opportunity to resolve eligible pending appeals. More information is available online.