Medicare Program; Appellant Forum Regarding the Administrative Law Judge Hearing Program for Medicare Claim Appeals
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Notice of Meeting.
Citation: "79 FR 393"
SUMMARY: This notice announces an
DATES: Meeting Date:
Deadline for Registration of Attendees and Requests for Special Accommodation: The deadline to register to attend the
ADDRESSES: Meeting Location:
We are exploring the feasibility of providing a toll-free phone line and/or live stream technology and/or webinar. Information on these options will be posted at a later date on the OMHA Web site; http://www.hhs.gov/omha/index.html.
Registration and Special Accommodations: Individuals wishing to attend the
FOR FURTHER INFORMATION CONTACT:
OMHA serves a broad sector of the public, including
OMHA was established in
At the time of OMHA was established, it was envisioned that OMHA would receive the traditional claim and entitlement appeals workload from the Medicare Part A and Part B programs, and the Medicare Part C Medicare Advantage program; and a new workload of appeals from the Medicare Part D Prescription Drug program and the Income Related Monthly Adjustment Amount (IRMAA) premium surcharges assessed by the
As a result of the anticipated workload increase from the traditional appeals and the increased workload resulting from MSA appeals and the RA program, a backlog of appeals began to form in fiscal year 2012 in which more requests for hearing were being filed than could be adjudicated. In 2013, appealed claims related to the RA program grew to over 136,000, further exacerbating the backlog of cases and resulting in a substantial increase in the adjudication time frame.
As the unprecedented growth in claim appeals continues to exceed the available adjudication resources to address appeals, OMHA is taking measures to mitigate the workload increase and planning future activities to bring efficiencies to the appeals process at the OMHA-level. One of the immediate measures has been to ensure that the relatively small numbers of beneficiary-initiated appeals are being immediately addressed by prioritizing their cases. For the remaining cases, OMHA has suspended assignments of new requests for hearing until an adjudicator becomes available, which will allow cases to be assigned more efficiently on a first in/first out basis as an Administrative Law Judge's case docket is able to accommodate additional workload. In addition, OMHA is vigorously pursuing an electronic case adjudication processing environment (ECAPE) to bring new efficiencies and appellant-access to the OMHA-level of the appeals process.
A. Format of the
As noted in section I. of this notice, OMHA is conducting this outreach to appellants of the
The majority of the forum will be reserved for presentations of workload data, processes and policy discussions, and recommendations from agency presenters. The time for each presentation will be approximately 30 to 60 minutes and will be based on the material being addressed in the presentation.
Questions and comments from in-person attendees will be solicited at the end of each planned presentation and during a separate question and answer session as time permits. In addition, questions related to the OMHA-level of the
B. Conference Call, Live Streaming, and Webinar Information
<p>   For participants who cannot attend the
Disclaimer: We cannot guarantee reliability for live streaming technology and/or a webinar.
III. Registration Instructions
The OMHA Executive Office is coordinating attendee registration for the
After completing the registration, online registrants will receive a confirmation email which they should bring with them to the meeting(s). If you are unable to register online, you may register by sending an email to [email protected]. Please include your first and last name, title, organization, address, office telephone number, and email address. If seating capacity has been reached, you will be notified that the meeting has reached capacity.
IV. Security, Building, and Parking Guidelines
Security measures include the following:
* Presentation of photographic identification to the Federal Protective Service or Guard Service personnel.
* Passing through a metal detector and inspection of items brought into the building. We note that all items brought to the
Note: Individuals who are not registered in advance will not be permitted to enter the building and will be unable to attend the forum in person. The public may not enter the building earlier than 45 minutes prior to the convening of the forum.
Attendees must enter the
Parking in Federal buildings is not available for this event. In addition, street side and commercial parking is extremely limited in the downtown area. Attendees are advised to use Metro-rail to either the Federal Center SW station (Blue/Orange line) or the
(Catalog of Federal Domestic Assistance Program No. 93.770, Medicare--Prescription Drug Coverage; Program No. 93.773, Medicare--
Chief Administrative Law Judge,
[FR Doc. 2013-31461 Filed 1-2-14;
BILLING CODE 4150-46-P
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