tci Part B Insider - 2015 Issue 22

Appeals: Medicare Appeals Could Change Dramatically

Early stage appeals need to be more accurate. Nearly everyone agrees that Medicare’s appeal system has essentially stopped functioning, but will a fix create an even bigger burden for you? Recent congressional action on the matter is shedding light on the issue. Last month, the U.S. Senate Finance Committee convened a hearing to discuss the Medicare claims appeals backlog. The Committee heard from the HHS Office of Medicare Hearings and Appeals’ (OMHA) Chief Administrative Law Judge Nancy Griswold, as well as other industry stakeholders. Committee Chair Sen. Orrin Hatch (R-Utah) and Ranking Member Sen. Ron Wyden (D-Ore...

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