Monday, August 17, 2020

OMHA Medicare Appeals Settlement Conference Facilitation - 2020 Expansion

Dan Ciolek

The United States Department of Health and Human Services (HHS) recently announced that the Office of Medicare Hearings and Appeals (OMHA) Settlement Conference Facilitation (SCF) 2020 Expansion is now open to the appellant community. SCF is an alternative dispute resolution process at OMHA. The process brings certain providers/suppliers and the Centers for Medicare & Medicaid Services (CMS) together to discuss the potential of a mutually agreeable resolution for eligible Medicare Part A and Part B claims appealed to OMHA or the Medicare Appeals Council (Council).

The 2020 SCF Expansion will increase the number of appeals eligible for SCF. Specifically, appeals involving request(s) for Administrative Law Judge (ALJ) hearing or Council review filed by the appellant on or before March 31, 2020 may now be eligible for SCF.  

All Medicare Part A and Medicare Part B providers and suppliers who have OMHA or Council appeals pending are encouraged to read the updated SCF 2020 expansion materials on the OMHA website. This includes a detailed discussion of the SCF process, updated eligibility criteria and required forms and documents, a revised settlement agreement template for this expansion, and a revised Frequently Asked Questions.  

SCF information is available here: https://www.hhs.gov/about/agencies/omha/about/special-initiatives/settlement-conference-facilitation/index.html.


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