On November 3, 2017, the Centers for Medicare & Medicaid Services (CMS) announced the addition of another settlement option for providers and suppliers (appellants) with appeals pending at the Office of Medicare Hearings & Appeals (OMHA) and the Medicare Appeals Council at the Departmental Appeals Board (DAB). The low volume appeals (LVA) settlement option will be limited to appellants with a low volume of appeals pending at OMHA and the Council – those with fewer than 500 Medicare Part A or Part B claim appeals pending at OMHA and the Council, combined, as of November 3, 2017, with a total billed amount of $9,000 or less per appeal could potentially be eligible, if certain other conditions are met. CMS will settle eligible appeals at 62% of the net allowed amount.

In addition, OMHA will be expanding the Settlement Conference Facilitation (SCF) Process for certain appellants that are not eligible for the LVA option. The SCF is an alternative dispute resolution process at OMHA and gives certain providers and suppliers an opportunity to resolve their eligible Part A and Part B appeals.