Low Volume Appeals Settlements

As part of the broader HHS commitment to improving the Medicare appeals process, CMS will make available an additional settlement option for providers and suppliers (appellants) with appeals pending at the Office of Medicare Hearings and Appeals and the Medicare Appeals Council at the Departmental Appeals Board. See the Appeals Settlement Initiatives website for more information. Specifically, appellants with fewer than 500 Medicare Part A or Part B claim appeals pending at OMHA and the Council, combined, as of November 3, 2017, with a total billed amount of $9,000 or less per appeal could potentially be eligible, if certain other conditions are met. CMS will settle eligible appeals at 62% of the net allowed amount.

Source: https://www.cms.gov/Outreach-and-Education/Outreach/FFSProvPartProg/Downloads/2017-11-09-eNews.pdf