ALSO IN THE NEWS

OMB to Review Medicare Appeals Procedures – The Office of Information and Regulatory Affairs (“OIRA”) within the Office of Management and Budget (“OMB”) is set to review new Medicare appeals process proposed rulemaking.  According to OIRA’s website, the rule would change “fee-for-service claim appeals, managed care organization determination appeals and prescription drug plan coverage determination appeals to increase administrative efficiencies . . . [and] address the increasing number of appeals in a manner that is responsive to appellants needs for timely determinations . . .”  The rulemaking comes against a backdrop of increased concern over slow appeals within HHS’s Office of Medicare Hearings and Appeals (“OMHA”).  A recent Senate report estimated that OMHA’s backlog of cases is near 1,000,000 and cases take 20 to 24 weeks to even be docketed.  OIRA’s review is done pursuant to Executive Order 12866, whereby OIRA is to evaluate “significant regulatory actions” prior to publication in the Federal Register.