OMHA expands eligibility for settlements

Thursday, August 13, 2020

WASHINGTON – The Office of Medicare Hearings and Appeals has extended the eligibility requirements to participate in a Settlement Conference Facilitation to appeals filed on or prior to March 31, 2020, that are pending at the administrative law judge hearing or Medicare Appeals Council review level, AAHomecare and the van Halem Group report. CMS launched the Settlement Conference Facilitation pilot program in July 2014 as an alternate dispute resolution process designed to bring the appellant and CMS together to discuss the potential of a mutually agreeable resolution for claims appealed and awaiting a hearing. “Based on the success with this program, and to make a dent in the existing ALJ backlog, the SCF program has been expanded yet again,” the van Halem Group wrote in a bulletin.