June 17, 2015

On June 3, 2015, the Senate Finance Committee passed an original bill that aims to streamline and improve the Medicare Audit and Appeals Process. The Medicare appeals process has recently faced scrutiny from industry leaders for inefficiencies and a growing, almost two-year backlog of requests at the Office of Medicare Hearings and Appeals (OMHA) for hearings in front of an administrative law judge (ALJ).

Critics of the proposal note that the bill does not adequately address underlying issues in the Medicare appeals process. Nevertheless, providers should remain cautiously optimistic that proposed changes in the bill may address inefficiencies that have prevented timely recovery of improperly denied claims.

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