OMHA’s new eligibility requirements are intended to benefit more providers. The Office of Medicare Hearings and Appeals (OMHA) has expanded its Settlement Conference Facilitation (SCF) program, and it is now open to the appellant community. By way of background, Settlement Conference Facilitation (SCF) is an alternative dispute resolution process designed…
OMHA adds Chapter 14 to its case processing manual The Office of Medicare Hearings and Appeals (“OMHA”) has recently been updating its OMHA Case Processing Manual (“OCPM”). The OCPM was originally released in 2015 to regulate and codify procedures for adjudicative functions by using statutes, regulations, and OMHA directives as…
OMHA Issues Updates to Its Case Processing Manual The Office of Medicare Hearings and Appeals (OMHA) announced updates to its OMHA Case Processing Manual (OCPM), which was first released in 2015. The purpose of the OCPM is to standardize and memorialize the day-to-day procedures for carrying out adjudicative functions in…
Providers urged to review potentially eligible claims and consider participation in the expanded SCF process. The Office of Medicare Hearings and Appeals (OMHA) publicly implemented the long-awaited expansion to its Settlement Conference Facilitation (SCF) process on June 15. SCF is an alternative dispute resolution process that provides appellants and the…
OMHA also announced that the SCF expansion will include a “fast track” process, or “SCF Express.” The Office of Medicare Hearings and Appeals (OMHA) hosted a Medicare Learning Network (MLN) conference call to release details regarding the long-awaited expansion to the Settlement Conference Facilitation (SCF) program on May 22, 2018.…
June 8, 2018 is the deadline for participation. Like watching the sunset approach the horizon, time is running out for hospitals and health systems weighing their participation in new initiatives being offered by the Office of Medicare Hearings and Appeals (OMHA) to settle backlogged claims at the Administrative Law Judge…
Two new programs have significant potential in collectively effectuating a meaningful reduction in the appeals backlog. In casting a larger net, the Office of Medicare Hearings and Appeals (OMHA) hopes to engage more providers and suppliers in settlement agreements as it seeks to improve the Medicare claims appeals process by…
The guy either has no idea how the process works or he has mastered the art of lying with statistics. In May 2014, the American Hospital Association (AHA) sued the Secretary of Health and Human Services (HHS) in an attempt to force the government to do something about the ridiculous…
The CMS announcement will be discussed in a conference call on Jan. 9, 2018. Healthcare providers and suppliers with fewer than 500 appeals pending at the Office of Medicare Hearings and Appeals (OMHA) and the Medicare Appeals Council could be eligible to participate in a new low-volume appeals (LVA) settlement…
A low volume appeals settlement and an expanded Settlement Conference Facilitation process are two initiatives to improve the Medicare claims appeal process. On Friday, the Centers for Medicare & Medicaid Services (CMS) and the Office of Medicare Hearings and Appeals (OMHA) announced two new settlement options for Medicare providers and…
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