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Arnall Golden Gregory LLP

Healthcare Providers Could Finally Have Their Day in Court: Supreme Court Holds That Defendants Are Entitled to Jury Trials When...

Arnall Golden Gregory LLP on

On June 27, 2024, the Supreme Court of the United States released its opinion in SEC v. Jarkesy, a case involving a Securities and Exchange Commission (“SEC”) enforcement action for civil penalties against an investment...more

Mintz - Health Care Viewpoints

HHS Announces a “Settlement Express” Option for Medicare Appeals

Mintz - Health Care Viewpoints on

HHS’s Office of Medicare Hearings and Appeals (OMHA) has long faced a backlog in Medicare appeals to Administrative Law Judges (ALJs). In an effort to address this backlog, OMHA established a Settlement Conference...more

Polsinelli

Four Key Takeaways on the Expansion of the Medicare Appeals Settlement Conference Project

Polsinelli on

On October 15, 2015, the Office of Medicare Hearings and Appeals (“OMHA”) conducted a teleconference to address Phase II of the Settlement Conference Facilitation (“SCF”) Pilot, effective October 1, 2015. SCF, launched in...more

Williams Mullen

Affirming the Need to Fix the Medicare Appeals Backlog: The AFIRM Act of 2015

Williams Mullen on

If you are one of the many health care providers wanting to appeal a Medicare contractor’s reimbursement decision, you may need to be prepared for a long wait. Over the last few years, the backlog of appeals to the...more

Polsinelli

Senate Committee Passes Bill Addressing Medicare Appeals Inefficiencies

Polsinelli on

On June 3, 2015, the Senate Finance Committee passed an original bill that aims to streamline and improve the Medicare Audit and Appeals Process. The Medicare appeals process has recently faced scrutiny from industry leaders...more

King & Spalding

Senate Finance Committee Holds Hearing Regarding Medicare Appeals Backlog

King & Spalding on

On April 28, 2015, the Senate Finance Committee held a hearing titled “Creating a More Efficient and Level Playing Field: Audit and Appeals Issues in Medicare.” The hearing included testimony from Office of Medicare Hearings...more

Foley & Lardner LLP

DME Suppliers, Get More Information on Your Medicare Appeals

Foley & Lardner LLP on

A new Office of Medicare Hearings and Appeals (OMHA) website offers intel on reimbursement appeal status, but does little to speed up the appeal process or eliminate the current backlog. It does, however, provide useful...more

King & Spalding

CMS Issues 2013 RAC Report to Congress

King & Spalding on

On September 29, 2014, CMS released the Fiscal Year (FY) 2013 Recovery Audit Contractor (RAC) report. According to the report, RACs collected $3.65 billion in Medicare overpayments during FY 2013. In addition, the report...more

Burr & Forman

CMS Offers To Settle All Acute Care Inpatient Claim RAC Appeals

Burr & Forman on

CMS is offering to pay hospitals 68 percent of the allowable amount for all claims that are currently on appeal. Specifically, CMS is offering to settle "inpatient status" claims at 68 percent of the "net paid amount" within...more

Poyner Spruill LLP

Hospitals File Lawsuit Over Medicare ALJ Hearings Delays

Poyner Spruill LLP on

Over 460,000 appeals requesting hearings before an administrative law judge (ALJ) were pending in the Office of Medicare Hearings and Appeals (OMHA) at the end of 2013, with 15,000 new appeals being submitted each week. At...more

Baker Donelson

Highlights from OMHA's Medicare Appellant Forum

Baker Donelson on

The Office of Medicare Hearings and Appeals (OMHA) recently announced that for most hearing requests received after April 1, 2013, it will be deferring assigning to Administrative Law Judges (ALJs). OMHA will continue to...more

Mintz - Health Care Viewpoints

Government Imposes Moratorium on Medicare Hearings and Appeals

Mintz - Health Care Viewpoints on

The Federal Office of Medicare Hearings and Appeals (OMHA) was established in July 2005 to administer the Medicare appeals program. OMHA adjudicates appeals regarding Medicare entitlement and Medicare provider reimbursement....more

King & Spalding

OMHA Imposes 24-Month Stay for New ALJ Assignments; Announces Medicare Appellant Forum

King & Spalding on

The Office of Medicare Hearings and Appeals (OMHA) has issued a Memorandum to OMHA Medicare appellants announcing a temporary stay, effective for cases filed on or after July 15, 2013, in the assignment of new requests for...more

King & Spalding

ALJ Hearing Assignment Suspension

King & Spalding on

As some of you may be aware, the Office of Medicare Hearings and Appeals (OMHA) has recently announced that it temporarily suspended the assignment of most new requests for Administrative Law Judge (“ALJ”) hearings, as of...more

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