Friday, December 22, 2017

CMS Call Scheduled on New Low Volume Appeals Settlement Option

Lilly Hummel

In November 2017, the Centers for Medicare and Medicaid Services (CMS) 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. CMS has announced a call to describe the process on Tuesday, Jan 9 from 1:30-2:30ET. Q&A is not available but questions may be submitted in advance to  MedicareSettlementFAQs@cms.hhs.gov.

LVA 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: https://www.cms.gov/Medicare/Appeals-and-Grievances/OrgMedFFSAppeals/Appeals-Settlement-Initiatives/index.html.

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