OMHA addresses appeals controversy at public session

The American Orthotic & Prosthetic Association attended a public session on Feb. 12 held by the Office of Medicare Hearing Appeals regarding recent actions to limit immediate provider access to administrative law judge hearings.

At the session, Nancy Griswold, chief judge for the 65 administrative law judges (ALJs), stated the Office of Medicare Hearing Appeals (OMHA) has resumed assigning a limited number of backlogged cases to some administrative law judges as their current backlog eases, but did not characterize the deferral in the process of assigning cases as a freeze in ALJ hearing appeals. According to a statement from the American Orthotic & Prosthetic Association (AOPA), Griswold provided data showing ALJs were reviewing more than twice as many cases per day as they were a few years ago, and outlined several new long-term initiatives to increase efficiencies, including mediation, attorney reviews and statistical sampling. Griswold also announced a pending plan to allow electronic tracking of the status of appeals.

AOPA also learned that CMS retained experts to train ALJs to help ensure the role of the Medicare program in these appeals is understood.

In an effort to raise awareness on these and other issues, AOPA will be holding a policy forum, April 2-4 in Washington, DC. For more information, visit www.aopanet.org/legislative-regulatory/2014-policy-forum/.

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