George Breen Quoted in "Medicare Appeals Board Drops Under-the-Radar Rule Changes"

Hospitals can appeal certain Medicare payment decisions to an independent board, but with all the landmines involved, it’s kind of like playing the board game Operation. …

Attorneys familiar with the new rules say they’re being released in conjunction with the board’s shift to using an electronic filing system like that of the federal courts. It’s a shift many agree will make the filing process easier for all parties. Currently, parties can submit to the board both electronically and using paper mail while kinks in the e-filing system are worked out, but Swayne said eventually that will all be done electronically. The CMS, which declined to comment for this article, has released a manual to help providers transition to the electronic filing process. …

Hospitals used to file final position statements at the end of an appeal, but those are now optional, said George Breen, who chairs Epstein Becker Green’s national healthcare and life sciences practice steering committee.

“I think there is the reflection of the notion of putting the issues up front and before the board much earlier on in the process,” Breen said. “I think that is a significant change.” …

The goal behind moving to an electronic filing system is to make the board’s appeal process more efficient, Breen said. Whether that ultimately reduces the backlog of cases waiting to be heard remains to be seen.

“It’s a question of the board being able to rule on these issues and it’s a question of manpower and the parties actually getting before the board and having appeals heard or ruled on,” Breen said. “That issue of manpower, having sufficient resources, isn’t really impacted by the changes.”