Monday, November 6, 2017

CMS Announces New Low Volume Settlement Option for Medicare Appeals

Lilly Hummel

The Centers for Medicare and Medicaid Services (CMS) has announced a new low volume appeals settlement (LVA) option for providers with appeals pending at the Office of Medicare Hearings and Appeals (OMHA) and the Medicare Appeals Council. This new option is potentially available to providers that have fewer than 500 Medicare Part A or Part B claim appeals pending at both OMHA and the Council, with a total billed amount of $9,000 or less per appeal, in addition to other conditions. CMS will settle eligible appeals at 62% of the net allowed amount. See CMS’ website for additional details about the LVA option, which will be posted in the coming weeks: https://www.cms.gov/Medicare/Appeals-and-Grievances/OrgMedFFSAppeals/Appeals-Settlement-Initiatives/index.html 

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