The Office of Medicare Hearings and Appeals (OMHA) has issued the attached request for information (RFI) regarding its current initiatives at the Administrative Law Judge (ALJ) level to address the Medicare claim and entitlement appeals workload and backlog. Since its Feb. 12 Medicare Appellant Forum, OMHA has implemented two pilot programs to provide appellants with options to address claims at the ALJ appeal level. One program provides appellants with an option to use statistical sampling during the ALJ hearing process, enabling them to obtain a decision on large numbers of appealed claims based on a sampling of those claims. The other initiative provides appellants with an option for settlement conference facilitation with an independent OMHA facilitator to discuss potential settlement of claims with authorized settlement officials.
OMHA is specifically seeking suggestions for the current initiatives, as well as suggestions for other ways to address the current ALJ appeals backlog. OMHA also seeks input on any current regulations that apply to the ALJ level that could be revised to streamline the adjudication process. CHA will host a call to solicit member input on Nov. 24 at 1 p.m. (PT). To register for the call, please visit www.surveymonkey.com/s/OMHARFI. Comments on the RFI are due by 2 p.m. (PT) on Dec. 5.