Starting next month, providers will have a quicker option for resolving Medicare appeals disputes. The Centers for Medicare & Medicaid Services will begin offering streamlined settlements based on preliminary data.
The agency took more than an hour last week to explain its expanded settlement conference facilitation process, or SCF.
Under the plan, CMS would make an offer and then give providers seven days to accept or proceed with a longer-lasting route, one that currently has stretched longer than three years for many appellants. Initiatlly, a provider would have to submit a request in writing to CMS, which would then have 15 days to reply. If the agency chooses to take part, a settlement conference would occur within four weeks.
Lawyers expressed optimism that the alternative dispute resolution process would help clear the backlog, which now includes hundreds of thousands of pending appeals.
“The amount of appeals pending at OMHA are just astounding, so you’re going to need to do more, but these [measures] are getting there,” Nick Alarif, associate at McDermott Will & Emery and a former OMHA employee told Bloomberg.
