Part B Insider (Multispecialty) Coding Alert
Appeals Timeframes Continue to Lengthen
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Expect typical processing time for appeals decisions to exceed 540 days.
OMHA processing time has changed drastically in the past decade. In fiscal year 2009, average processing time was 94.9 days; 109.6 days in FY 2010; 121.3 days in FY 2011; 134.5 days in FY 2012; 220.7 days in FY 2013; 414.8 days in FY 2014; and 547.1 days in FY 2015. And check out these statistics for OMHA decisions:
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.
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