Posts Tagged ‘Medicare appeals backlog’
Inpatient Providers Settle Payment Dispute with CMS over Medicare Claims
The Centers for Medicare & Medicaid Services (CMS) has ended a two-year dispute settling appeals from inpatient rehabilitation facilities (IRF) over Medicare claims that were denied. The agency has agreed to pay 69 percent of the net payable amount for most claims that are pending appeal before the Medicare Administrative Contractor (MAC), the Qualified Independent…
Read MoreCMS Proposes Changes Designed to Speed up Medicare Appeals Process
It’s been a while since we last updated you on the latest about the Medicare appeals backlog, which although it has decreased some, remains troublesome. To further address the issue, The Centers for Medicare & Medicaid recently proposed revising its rules that govern the appeals process in an effort to further streamline it and reduce…
Read MoreHHS Takes Another Shot at Reducing Medicare Appeals Backlog
In an effort to clear the ever-growing Medicare appeals backlog, the U.S. Department of Health & Human Services has announced the launch of two new settlement options for providers and suppliers: a low-volume appeals (LVA) settlement and an expanded Settlement Conference Facilitation (SCF) process. LVA will be limited to appellants with a low volume of…
Read MoreStudy: Medicare Appeals Process Reforms Not Enough to Eliminate Backlog
The Centers for Medicare & Medicaid Services’ (CMS) current and proposed reforms may not be enough to eliminate the appeals backlog and restore a timely and fair appeals process. That was the finding of a study published recently in the Journal of Hospital Medicine. Researchers investigated all appeals reaching level three at three facilities: Johns…
Read MoreJudge Orders HHS to Clear Medicare Claims Appeal Backlog by 2020
Four years, that’s how long a federal judge has given the Department of Health and Human Services (HHS) to clear through a huge backlog of Medicare claims appeals. The Dec. 5 ruling, from Judge James E. Boasberg grew out of a motion for summary judgment filed in October by the American Hospital Association. At issue…
Read MoreCMS offers plan (again) in hopes of clearing Medicare appeals backlog
Hospital executives who are tired of waiting for their Medicare appeals cases to be settled are being presented with an option. The Centers for Medicare and Medicaid is offering to pay hospitals 66 percent of the net allowable for short-term inpatient stays in exchange for dropping their pending appeals of denied claims. CMS recently announced…
Read MoreWill proposed rule change clear Medicare appeal claims logjam?
The Department of Health and Human Services late last month took a small step toward easing a very big problem. The agency issued a proposed rule designed to help reduce the backlog of more than 700,000 Medicare claims stuck in the appeals process. The proposed changes to the Medicare appeals process would “streamline administrative processes,…
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