HHS to Launch Changed Medicare Appeals Process

New procedures mandated by the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 will soon offer quicker resolution to appeals by Medicare beneficiaries, providers and suppliers.

The Medicare hearings function, currently handled by the Social Security Administration (SSA), will transition on July 1, 2005 to the Office of Medicare Hearings and Appeals (OMHA) located within the Department of Health and Human Services (HHS). The changes will help ensure that fee-for-service Medicare claims appeals are resolved within the 90-day timeframe mandated by the Medicare, Medicaid, and SCHIP Benefits Improvement and Protection Act of 2000 (BIPA).

"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," HHS Secretary Mike Leavitt said. "Our goal is to eliminate the need for an aged or disabled beneficiary to travel if other resources are available closer to home."

HHS anticipates it can reduce hearing timeframes to comply with the BIPA requirements by using video teleconferencing technology (VTC) with a state-of-the-art electronic hearings process to provide significantly more access points than currently exist. HHS has access to VTC sites in over 1,000 cities nationwide. ...

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U.S. Department of Health & Human Services

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