CMS launches initiative to reduce Medicare appeals backlog: 3 things to know

CMS has started a new initiative to help clear the mounting Medicare appeals backlog at the Administrative Law Judge level.

Here are three things to know.

1. CMS announced the new low-volume appeals settlement option in November 2017, and the agency launched the first round of the new initiative on Monday.

2. The low-volume appeals settlement option is limited to those with fewer than 500 Medicare Part A or Part B claim appeals pending with the Office of Medicare Hearings and Appeals and the Medicare Appeals Council as of Nov. 3, 2017, with a total billed amount of $9,000 or less per appeal. CMS will settle eligible appeals at 62 percent of the net allowed amount.

3. CMS launched the new settlement option to clear the significant backlog of Medicare appeals that has resulted in a nearly three-year adjudication process for each Medicare claim that is denied.

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