OMHA to expand settlement process for appeals

Tuesday, September 22, 2015

WASHINGTON – The Office of Medicare Hearings and Appeals will expand a pilot project that it launched last year that seeks to settle appeals that are stuck at the administrative law judge level.

OMHA has announced that it will hold a conference call on Oct. 15 to discuss its plans to expand its Settlement Conference Facilitation pilot project.

The office did not provide details on how it plans to expand the pilot project, but it stated: “The teleconference will brief appellants on how they can request SCF and detail the new SCF process.”

Part B providers who are interested in participating in the call need to complete a registration form* and email it to

As part of the pilot project, OMHA brings together the appellant and CMS to discuss resolving claims appealed to the ALJ level. If a resolution is reached, OMHA drafts a settlement document for both parties to sign. As part of the agreement, the request for an ALJ hearing is dismissed.

A recent analysis by AAHomecare revealed that the wait time for appeals at the ALJ level has increased nearly 25% during the first half of 2015. The average processing time at this level was 725 days in June.