Accession Number : ADA192363

Title :   Medicare Claims: HCFA (Health Care Financing Administration) Proposal to Establish an Administrative Law Judge Unit.

Corporate Author : GENERAL ACCOUNTING OFFICE WASHINGTON DC HUMAN RESOURCES DIV

PDF Url : ADA192363

Report Date : Apr 1988

Pagination or Media Count : 41

Abstract : This report briefed certain of your offices on our work relative to the requirement in section 4037 of the Omnibus Budget Reconciliation Act of 1987 to study the Health Care Financing Administration's (HCFA) proposal to establish, at a cost of about $15 million, its own hearings and appeals unit to handle Medicare cases. A special feature of this proposal was HCFA's projection that administrative law judges (ALJs) located in this unit would handle 50 percent of the appeals over the telephone. HCFA's proposal was presented to the Congress for funding in the fall of 1987; the proposal was not approved primarily because of congressional concerns about conducting the hearings by telephone rather than face-to-face. We reviewed HCFA's documentation for its proposal and met with Department of Health and Human Services (HHS) officials responsible for developing the proposal and Office of Personnel Management officials responsible for approving and monitoring ALJs in federal agencies. We also discussed the proposal with health service provider associations, national associations representing the elderly, and Medicare claims processing contractors who currently use telephone hearings.

Descriptors :   *MEDICAL SERVICES, *FINANCIAL MANAGEMENT, CONTRACTORS, COSTS, HEALTH, HUMANS, LAW ENFORCEMENT, MANAGEMENT, OFFICE PERSONNEL, PERSONNEL MANAGEMENT, PROCESSING, TELEPHONE SYSTEMS

Subject Categories : Administration and Management
      Medicine and Medical Research

Distribution Statement : APPROVED FOR PUBLIC RELEASE