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Tag: office of medicare hearings and appeals


Also Noted

DME appeals represent 42% of ALJ backlog, AAH says

March 12, 2021HME News Staff

WASHINGTON – The Office of Medicare Hearing and Appeals (OMHA) has shared with AAHomecare that there were 201,292 appeals in the ALJ backlog at the end of 2020, about 85,000 of which involved DME. That’s a significant drop from 2019, the association says, when there were 318,000 appeals in the ALJ backlog, about 173,000 of which involved DME. In past years, DME appeals have represented up to 55% of the ALJ backlog, AAHomecare says.

Administrative Law Judge, appeals, DMEPOS, office of medicare hearings and appeals


Editorial

Settlement process still long shot for many providers

November 13, 2015Theresa Flaherty, Managing Editor

WASHINGTON - The Office of Medicare Hearings and Appeals has made the settlement process slightly easier, but challenges remain, says AAHomecare's Kim Brummett.The biggest change OMHA has made: Providers can include appeals filed at the Administrative Law Judge level through Sept. 30, 2015. Previously, it was limited to appeals filed in 2013.“That's a much better deal,” said Brummett, senior director of regulatory affairs for AAHomecare. “Providers can settle on a much larger volume...

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Settlement process still long shot for many providers

November 13, 2015Theresa Flaherty, Managing Editor

WASHINGTON - The Office of Medicare Hearings and Appeals has made the settlement process slightly easier, but challenges remain, says AAHomecare's Kim Brummett.The biggest change OMHA has made: Providers can include appeals filed at the Administrative Law Judge level through Sept. 30, 2015. Previously, it was limited to appeals filed in 2013.“That's a much better deal,” said Brummett, senior director of regulatory affairs for AAHomecare. “Providers can settle on a much larger volume...

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Stakeholders to lawmakers: Stop the audit madness

February 7, 2014Theresa Flaherty, Managing Editor

WASHINGTON - A small but determined group of HME stakeholders will travel to Capitol Hill this week to take on audits.“We don't want to sit back and take it anymore,” said Lisa Willis, director of compliance for Jasper, Ala.-based Med-South. “We are at the point where you shut down the ALJs, and they've dragged their feet on all of the other audit (problems).”The Office of Medicare Hearings and Appeals (OMHA) will host a daylong forum Feb. 12 to discuss an increased workload...

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Also Noted

Conference call, webinar set for audit forum

February 4, 2014HME News Staff

WASHINGTON - Those unable to attend the Feb. 12 Office of Medicare Hearings and Appeals Medicare Appellant Forum may now register to listen in through a conference call or webinar. Remote participation is open to the first 500 registrants and is “listen only,” according to a release from the Department of Health and Human Services. During the forum, the OMHA plans to provide an update on the status of its operations, and to share information about initiatives to mitigate the backlog of...

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Registration extended for audit forum

January 29, 2014HME News Staff

WASHINGTON - The VGM Group is urging providers to attend the Feb. 12 Office of Medicare Hearings and Appeals' Medicare Appellants Forum and has reserved a block of hotel rooms for attendees at the Embassy Suites in Crystal City. VGM will host a meeting the night of Feb. 12 to discuss the forum and plans for the next day. Registration for the forum has been extended to Jan. 31. The event is free, but participants must register in advance, and there is a 400-person capacity, the bulletin notes.

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Poll: 41% have been waiting at least one year for hearing

November 15, 2013Leah Hoenen

YARMOUTH, Maine - Long delays have made appealing denied claims a painful process for HME providers, forcing them to wait sometimes years for payment.Nearly all of the 120 respondents to the December HME NewsPoll (91%) say they have one or more appeals awaiting a hearing with an administrative law judge (ALJ), the third level of appeal. Forty-one percent of respondents say they've already been waiting at least a year.“Many of these claims are showing up as open invoices on our books and presenting...

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Coalition seeks fix to 'feeding frenzy' of audits

November 15, 2013Liz Beaulieu, Editor

WASHINGTON - A new coalition led by a long-time industry healthcare attorney and former White House and Health and Human Services (HHS) advisers has made audit relief its singular priority.The Medicare Appeals Due Process Coalition will work on behalf of HME providers to reform the appeals process for audited and denied claims.“It's important to get different types of providers together and raise their voice with CMS and Congress to see if we can get this fixed,” said Jennifer Summa,...

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In brief: Gov't delays hearings, Cardinal highlights AssuraMed

November 1, 2013HME News Staff

WASHINGTON - The Office of Medicare Hearings and Appeals (OMHA) will defer assignments for hearings—possibly up to 28 months, according to a recent notice. Requests for hearings received after July 15, 2013, will be entered into the agency's case processing system and held until there is room on an Administrative Law Judge's (ALJ) docket for adjudication. When a request is assigned, a notice will be sent, according to the notice. The ALJs have been backlogged for more than a year, thanks...

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