Long-Term Care

LTC providers will be able to appeal Medicare claims without ALJ

MDS 3.0 Insider, July 10, 2014

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Long-term care providers will be able to appeal certain Medicare claims decisions without utilizing an administrative law judge, the Centers for Medicare & Medicaid Services announced Thursday.

Settlement Conference Facilitation is an alternate dispute resolution process that would bring providers and CMS representatives together to negotiate and settle Medicare disputes with the help of a third party. This settlement conference facilitator would be an employee of the Office of Medicare Hearings and Appeals, which is a separate agency from CMS, according to a fact sheet on the pilot program.

 

 

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