HHS Announces Plans to Shorten Medicare Appeals Process

WASHINGTON–After taking control of the Medicare appeals process
at the start of the month, the Department of Health and Human
Services said last week that it plans to use technology to speed up
the process and increase access to hearings.

One way the agency said it will reduce hearing times is by
increasing use of video teleconferencing technology to hold
electronic hearings. HHS currently has access to VTC sites in more
than 1,000 cities. If an in-person hearing is required, according
to the agency, an Administrative Law Judge will travel to a
location convenient to the parties involved.

Despite concerns that have been raised about possible staffing
shortages (See HomeCare
Monday, April 4), HHS said the new approach will bring
quicker resolution to fee-for-service Medicare claims, which must
be resolved within a 90-day timeframe under a mandate in the
Medicare, Medicaid and SCHIP Benefits Improvement and Protection
Act of 2000. The ALJ function moved from the jurisdiction of the
Social Security Administration to HHS under a requirement in the
MMA.

“As HHS assumes responsibility for handling Medicare hearings,
we are committed to making the appeals process better, faster and
more convenient for seniors and other people with Medicare,” said
HHS Secretary Michael Leavitt. “Our goal is to eliminate the need
for an aged or disabled beneficiary to travel if other resources
are available closer to home.”

The transfer is among the first steps in the government’s plan
to reform the Medicare claims appeals process. For more
information, visit HomeCare
Monday, June 27 and the
Office of Medicare Hearings and Appeals.