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Medicare Part A Administrative Appeals

King & Spalding

CMS Issues Final Rule Implementing Changes to Medicare Appeals Procedures

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On May 3, 2019, CMS issued its final rule implementing changes to the appeal procedures for Medicare claims and Medicare prescription drug coverage determinations (the Final Rule). The Final Rule will be published in the...more

Baker Donelson

The New Option in Town: Applying for the Low Volume Appeals Settlement

Baker Donelson on

In November 2017, the Department of Health and Human Services (HHS) announced new settlement options for providers and suppliers stuck in the backlog of the Medicare appeals process. One of the new options available is the...more

King & Spalding

Office of Medicare Hearings and Appeals Launches Settlement Conference Facilitation Pilot for Medicare Part A Claims

King & Spalding on

The HHS Office of Medicare Hearings and Appeals (“OMHA”) recently launched Phase III of the Settlement Conference Facilitation (“SCF”) Pilot to help resolve outstanding Medicare Part A appeals. The SCF program is one of...more

King & Spalding

OIG Reports on The First Level of the Medicare Appeals Process

King & Spalding on

The HHS Office of Inspector General (OIG) recently published the results of a study regarding the first level of the Medicare Parts A and B appeals process, or redeterminations, for years 2008 through 2012. The report...more

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