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Medicare Claims Appeals Process Administrative Appeals

Bass, Berry & Sims PLC

Judicial Opinions Support Delay of Recoupment from Audit Appeals Until After ALJ Hearings in Certain Circumstances

Bass, Berry & Sims PLC on

Recent opinions by the Fifth Circuit, the Northern and Southern Districts of Texas, and the District of South Carolina offer hope to providers seeking relief from substantial monetary recoupments during the Medicare appeals...more

Baker Donelson

HHS Expands Settlement Conference Facilitation for Medicare Claims Appeals

Baker Donelson on

The Department of Health and Human Services (HHS) announced on November 3, 2017 additional settlement options for providers and suppliers in an effort to improve the Medicare claims appeals process, which included (1) the Low...more

Baker Donelson

Proposed Enrollment Rule Changes - de Facto Exclusion?

Baker Donelson on

Proposed rules, touted as enhancing the provider enrollment process, would provide CMS with sanction authority that closely parallels the OIG’s exclusion authority. Under the proposed rules, CMS would have expanded bases to...more

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