The HHS Departmental Appeals Board (DAB) is inviting the public to submit recommendations for precedential Medicare Appeals Council (Council) decisions that will be binding on all CMS, HHS, and Social Security Administration components that adjudicate matters under CMS jurisdiction. The designation of precedential decisions was authorized by regulations adopted earlier this year; the DAB will publish notice of any precedential designations in the Federal Register.
CMS also announced that it will provide a low-volume appeals (LVA) settlement option for certain providers and suppliers with appeals pending at the Office of Medicare Hearings and Appeals (OMHA) and the Council. This option will be available for appellants with fewer than 500 total Medicare Part A or Part B claim appeals pending at OMHA and the Council as of November 3, 2017 with a total billed amount of $9,000 or less per appeal, subject to certain other conditions. Eligible appeals will be settled at 62% of the net allowed amount. In addition, OMHA intends to expand its Settlement Conference Facilitation (SCF) alternative dispute resolution process for certain appellants that are not eligible for the LVA option.
This article is presented for informational purposes only and is not intended to constitute legal advice.
