CHA News Article

New Mediation Pilot Program Aims to Reduce ALJ Appeals

The Centers for Medicare & Medicaid Services (CMS) has announced a new pilot program intended to alleviate the backlog of Medicare Part B claims that have been appealed to the Administrative Law Judge level. The program, Settlement Conference Facilitation, will offer an alternative dispute resolution process using a conference facilitator and mediation principles to help the appellant and CMS agree on a settlement. As an employee of the Office of Medicare Hearings and Appeals, the facilitator will not be a fact finder or make any determinations about the claimed issues, but will instead help each side to see the strengths and weaknesses of their cases.

Settlement Conference Facilitation is only for appeals of Medicare Part B Qualified Independent Contractor decisions. For more information on which appeals are eligible and how to request Settlement Conference Facilitation, visit www.hhs.gov/omha/settlement_conference_facilitation_pilot.html.

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