tci Part B Insider - 2015 Issue 22

Appeals Timeframes Continue to Lengthen

Expect typical processing time for appeals decisions to exceed 540 days. Due to the overwhelming receipt levels and already huge backlog of Medicare claims appeals, don’t hold your breath when you’re waiting for the HHS Office of Medicare Hearings and Appeals to hear your appeal. The average processing time for appeals decisions in 2015 is a whopping 547 days, and OMHA projects a 20- to 24-week delay in entering (“docketing”) new requests into its case processing system. OMHA processing time has changed drastically in the past decade. In fiscal year 2009, average processing time was...

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