The Centers for Medicare and & Medicaid Services (CMS) is accepting Expressions of Interest (EOIs) from Medicare fee-for-service providers to participate in its new Low Volume Appeals Initiative in lieu of the standard Medicare claims appeals process. The initiative is a settlement process for fee-for-service physicians, providers, and suppliers who have fewer than 500 appeals pending with the Office of Medicare Hearing and Appeals (OMHA) and the Medicare Appeals Council, combined, as of November 3, 2017, to settle their pending appeals. The appeals must have total billed amounts of $9,000 or less per appeal, and CMS will make a timely partial payment of 62 percent of the net Medicare-approved amount.
EOIs are based on the provider or appellant’s National Provider Identifier (NPI), and if the EOI is approved for participation, the settlement will apply to all eligible appeals from that appellant. The appellant cannot choose to settle some eligible appeals but not others.
For appellants with NPIs ending in an even number, EOIs will be accepted through March 9. For appellants with NPIs ending in an odd number, EOIs will be accepted from March 12 through April 11. Appellants with both odd and even NPIs must submit one EOI per NPI during the appropriate designated timeframe, as described above.
For details, visit CMS’ Low Volume Appeals Initiative webpage.