OMHA Expands Eligibility for Mediation of Medicare Appeals

The Office of Medicare Hearings and Appeals (OMHA) said June 7 that it has opened up settlement conference facilitation (SCF) to more appeals of Medicare claim denials. SCF, which is a dispute resolution process, is available to all Part A and B providers (and suppliers) for appeals that have been filed as late as March 31, 2019. OMHA’s newest addition, SCF Express, will accept higher-dollar appeals, and there doesn’t seem to be a cap on extrapolated overpayments that could be included.

“All the recent appeals that would have been filed are now eligible,” says attorney Andrew Wachler, with Wachler & Associates in Royal Oak, Michigan. “That’s significant.” It makes sense that OMHA expanded eligibility, because SCF is a tool to reduce the Medicare appeals backlog, which is the point of the process.

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