IRF Voluntary Appeals Settlement Options

Beginning June 17, 2019 CMS will accept Expressions of Interest for a settlement option for certain Inpatient Rehabilitation Facility (IRF) pending appeals at the following levels of review.

  • Redeterminations at the Medicare Administrative Contractor (MAC),
  • Reconsiderations at the Qualified Independent Contractor (QIC),
  • Administrative Law Judge (ALJ) Office of Medicare Hearings and Appeals (OMHA) and/or
  • Medicare Appeals Council.

CMS expects to include situations where appeal rights for IRF-related claims have not yet been exhausted at the QIC, OMHA and/or Council level. IRF appellants that filed appeals at the MAC for redetermination no later than August 31, 2018, that are currently pending or are eligible for further appeal at the MAC, QIC, OMHA, or Council, will have the opportunity to settle their eligible appeals.

Visit the IRF Appeals Initiative website for more information, including:

Source

  • CMS MLN Connects dated June 20, 2019

 

Last Updated Jul 08, 2019