The U.S. Department of Health and Human Services (HHS) released a Final Rule aimed at reducing and eventually eliminating the backlog of more than 650,000 claims currently awaiting adjudication by an administrative law judge...more
2/17/2017
/ Adjudicatory Process ,
Administrative Law Judge (ALJ) ,
Amount in Controversy ,
Centers for Medicare & Medicaid Services (CMS) ,
Decision-Making Process ,
Department of Health and Human Services (HHS) ,
Final Rules ,
Medicare ,
Medicare Advantage ,
Medicare Appeals Council ,
Medicare Claims Appeals Process ,
OMHA ,
Redeterminations
On June 28, 2016, the U.S. Department of Health and Human Services (HHS) released a series of regulatory changes in the Notice of Proposed Rule Making (NPRM) designed to curtail the massive backlog of Medicare claim appeals....more
On Feb. 25, 2016, the Office of Medicare Hearings and Appeals (OMHA) conducted a teleconference to address Phase III of the Settlement Conference Facilitation (SCF) project, which also became effective on Feb. 25, 2016. SCF,...more
On Jan. 20, 2016, a federal district court in the Western District of Texas affirmed a decision of the Medical Appeals Council (Appeals Council) affirming a CMS contractor’s extrapolation methodology used to assess an...more