Medicare Claims: HCFA Proposal To Establish an Administrative Law Judge Unit
HRD-88-84BR
Published: Apr 20, 1988. Publicly Released: Apr 20, 1988.
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Highlights
Pursuant to a legislative requirement, GAO reviewed the Health Care Financing Administration's (HCFA) proposed plan to establish its own hearings and appeals unit to handle Medicare hearings, at an estimated cost of $15 million.
Recommendations
Matter for Congressional Consideration
Matter | Status | Comments |
---|---|---|
Congress should require HCFA to test and evaluate the proposal to establish its own hearings and appeals unit separate from that of SSA before implementation. The issues that should be examined in a test include such factors as the: (1) mix of claimants appealing both part A and part B cases; (2) actual telephone acceptance rate of this proposal; (3) possible variations by type of claimant (for example, beneficiaries, physicians); (4) resulting time, case load, and cost of hearings; and (5) performance of the hearings in meeting due process requirements. |
Closed – Implemented
|
Congress did not fund the HCFA proposal. |
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Topics
Administrative hearingsAdministrative law judgesAgency missionsClaims settlementElderly personsHealth insuranceHealth insurance cost controlHealth services administrationMedical expense claimsMedicare