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CMS Launches New Low Volume Appeals Settlement Option

Wednesday, January 17, 2018   (0 Comments)
Posted by: Mandy Rubenstein
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The Centers for Medicare & Medicaid Services (CMS) is launching a new Low Volume Appeals (LVA) Initiative to help address the significant backlog of Medicare appeals that are currently in line for resolution. Under the program eligible providers and suppliers may submit an Expression of Interest (EoI) to CMS to be considered for an administrative settlement process to address a portion of pending appeals in exchange for a 62% partial payment of the net Medicare approved amount. Given the length of time that it is taking for Medicare appeals to be resolved, the National Association for Home Care & Hospice (NAHC) encourages eligible providers to examine the LVA Initiative as a potential option for addressing outstanding claim disputes.

On January 9, CMS held a brief National Provider Call during which the rudiments of the program were reviewed and a number of questions submitted in advance of the call were answered.

CMS plans to post an audio recording of the call within two weeks HERE.

Presentation slides for the January 9 call are available HERE.

In cases where providers are not eligible for the LVA option, the Office of Medicare Hearings and Appeals (OHMA) has been expanding the Settlement Conference Facilitation Process. Information on the Settlement Conference Facilitation Process is available at the following location: https://www.hhs.gov/about/agencies/omha/about/special-initiatives/settlement-conference-facilitation/index.html.

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