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CMS expands phone demo

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10/23/2018

JACKSONVILLE, Fla. – CMS will expand a demonstration project that allows HME providers to speak with reconsideration professionals by phone to try and resolve their cases to jurisdictions A and B on Nov. 1.

Lack of unified stance on settlements, poll finds

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10/12/2018

YARMOUTH, Maine – It turns out, even with the huge backlog of Medicare appeals stuck at the administrative law judge level, whether or not to accept a settlement is as divisive an issue as it gets in the HME industry.

Another court issues TRO on CMS

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07/24/2018

BROWNSVILLE, Texas – A court has again issued a temporary restraining order prohibiting CMS from recouping overpayments until after the administrative law judge level, this time on behalf of Adams EMS, according to healthcare attorney Elizabeth Hogue. In June, the U.S.

Court agrees broken appeals systems is unfair

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06/22/2018

DALLAS – A U.S. District Court’s recent opinion prohibiting CMS from recouping alleged overpayments from a provider going through the appeals process until after the administrative law judge level sends a strong message, industry stakeholders say.

Judge getting impatient with HHS over massive ALJ backlog

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Friday, April 6, 2018
Elizabeth Hogue

I recently wrote an article entitled "Court Says No Recoupment Until After ALJ Hearings."  This article was about a court decision in which the judge said that recoupment of an extrapolated overpayment as a result of a ZPIC audit could not begin until after ALJ hearings were held.

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HHS details status of appeals backlog

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11/29/2017

FALLS CHURCH, Va. – The Office of Medicare Hearings and Appeals receives more than a year’s worth of appeals work every 24 weeks at the third level of appeals, according to a recent PDF posted to the agency’s website.

Session spotlight: Be prepared for your day in court

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10/24/2017

ATLANTA – Many HME providers end up in front of an administrative law judge to contest a reimbursement denial, but too often they don’t know what they’re up against, says speaker Ross Burris.

CMS contractor expands phone demo

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11/04/2016

JACKSONVILLE, Fla. – C2C Innovative Solutions, the contractor handling the second level of the Medicare appeals process, has received the green light from CMS to expand a demonstration project that allows HME providers to speak with reconsideration professionals by phone to try and resolve their cases.

Court pressures HHS over audit backlog

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09/22/2016

WASHINGTON – A federal court has ordered the U.S. Department of Health and Human Services to solve the backlog at the Administrative Law Judge level, according to an update from The VGM Group. In a decision handed down Sept.

ALJ sides with feds, Lincare must pay $240K penalty

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02/04/2016

CLEARWATER, Fla. – Lincare will pay nearly $239,800 in civil monetary penalties for violating the Health Insurance Portability and Accountability Act, a U.S. Department of Health and Human Services Administrative Law Judge ruled Feb. 3.

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