October 27, 2015
On October 15, 2015, the Office of Medicare Hearings and Appeals (“OMHA”) conducted a teleconference to address Phase II of the Settlement Conference Facilitation (“SCF”) Pilot, effective October 1, 2015. SCF, launched in June 2014, is an alternative dispute resolution process for eligible claims pending appeal in front of an Administrative Law Judge. OMHA also announced that it plans to expand the settlement conference option to Part A claims as part of Phase III, which will begin sometime in 2016.

What You Need to Know:

Eligible Part B claims filed before September 30, 2015 may now be eligible for settlement in Phase II. Providers should carefully consider the pros and cons of settling eligible claims, or letting them remain pending for an ALJ hearing. Providers should also prepare for the Phase III expansion for Part A claims. In addition, Polsinelli's experience in advising and representing clients throughout the Medicare Appeals Process could be valuable to providers as the SCF Pilot Program continues to expand. More information about the Phase II Process can be found here.

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