Wait time for Medicare appeals halved

Through Medicare, millions of seniors gain access to health care options which are affordable. However, similar to systems which are government funded, there can be problems along the way. When the coverage for a claim is in dispute, the beneficiaries of the service may be required to file an appeal and request for an appointment with a judge to get the matter solved. For Medicare recipients, unfortunately the waiting time can be long and sometimes, some cases may not be heard at all in a year. Those seniors who are waiting for rulings to determine the result of health care decisions, such a setback can be quite deadly.

The past few years have not been very promising for beneficiaries of Medicare who have been waiting for rulings on their appeal. The Washington Post stated that in 2013, 1,493 beneficiary cases were left without a decision being reached. This is almost 1/3rd of all the appeals which were filed and in addition to this, the 1,705 cases of 2012 too are not resolved as yet which also accounts for almost half of the cases which were filed in that year.

According to the source, the reason behind why so many cases remaining unresolved is that the recipients of Medicare present a small percentage of claims only which require a ruling to be made. Most of the cases come from health care providers and hospitals. This is mostly because of disputes on Medicare coverage of observation care for seniors.

To cut down what a number of people view as being an unacceptable amount of time wait for beneficiary claims, a new ruling was passed by the chief judge of the Office of Medicare Hearings and Appeals, Nancy Griswold. In her primary initiative, she noted that appeals which come from care providers or hospitals are to be put on hold for the next 2 years. This is going to help the OMHA in prioritizing cases from Medicare beneficiaries.

As it stands, the measure has reduced the waiting time for claims to an average of 113 days which is less than half of the resolution wait time which was present in 2013 when cases needed an average of 235 days to be seen by a judge according to the Wall Street Journal. Despite such a drastic reduction, the source also indicated that this is still falling short of the 90 day maximum wait period which has been mandated by the government.

Medicare provides a number of seniors with access to preventive and medical care which is covered by the government. However it must be kept in mind that a major part of senior care is lifestyle adjustments. Older adults need to be encouraged to exercise on a regular basis and to eat a diet which is not only healthy but balanced as well. This is one way in which potentially complicated issues can be avoided and their health can be maintained. This will also come in handy given the long waiting time.


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