FutureFocus May 9, 2018: Revising Conditions Of Participation To Increase Data Sharing

Lisa Remington

In this week’s FutureFocus, is the announcement of CMS discussing a Request for Information (RFI) for feedback on solutions to achieve better data sharing between providers. A similar RFI was announced recently in FY 2019 PPS updates. There is a possibility of revising Conditions of Participations. Another merger between three home care companies will form one of the largest providers of home-based care in the U.S. In another announcement, Humana and Landmark announce an in-home care program for chronic conditions.

Lisa Remington, President, Remington Health Strategy Group

CMS has scheduled an Alternative Dispute Resolution Initiative Call for May 22, 1:30-3 pm ET. Register through Medicare Learning Network events.

As part of the broader commitment by HHS to improve the Medicare claims appeals process, the Office of Medicare Hearings and Appeals (OMHA) is expanding the current Settlement Conference Facilitation (SCF) program to reach additional providers and suppliers. SCF is an alternative dispute resolution process that gives certain providers and suppliers an opportunity to resolve their eligible Part A and Part B appeals pending at OMHA and the Medicare Appeals Council.

During this call, providers will be informed of the newly expanded SCF Initiative, which appeals are eligible for SCF, and the SCF process. A question-and-answer session follows the presentation; however, attendees may email questions in advance to OMHA.SCF@hhs.gov with “SCF May 22 Call” in the subject line. These questions may be addressed during the call or used for other materials following the call. Register for the call here.

Target Audience: Medicare Part A and Part B providers and suppliers with a total of 500 or more appeals pending at OMHA and the Council combined; or Medicare Part A and Part B providers and suppliers with any number of appeals pending at OMHA and the Council that each have more than $9,000 in billed charges.

SCF is separate and distinct from the CMS Low Volume Appeals Settlement Option.


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