By Sandra Gauron, Appeals Coordinator
The Centers for Medicare & Medicaid Services (CMS) has provided an alternative dispute resolution to filing an appeal to an Administrative Law Judge (ALJ) in order to prevent backlog since July 2014. The Settlement Conference Facilitation (SCF) is designed to bring the appellant and CMS together to discuss the potential of a mutually agreeable resolution for Medicare Part A and Part B claims appealed to the Office of Medicare Hearings and Appeals (OMHA) level or the Medicare Appeals Council (Council) level of the Medicare claims appeals process.
This year, the SCF has expanded to increase the number of appeals eligible for SCF. Specifically, appeals involving request(s) for ALJ hearings or Council reviews filed by the appellant on or before June 30, 2021.
For specific eligibility and process instruction, please refer to the following website: https://www.hhs.gov/about/agencies/omha/about/special-initiatives/settlement-conference-facilitation/index.html
Do you qualify for the SCF? Are you interested in pursuing a SCF? Let us help!