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Office of Medicare Hearings and Appeals (OMHA)

Decision Statistics

 
Appeals FY12 FY13 FY14 FY15
 
FY16
(Data through March 2016)
Fully Favorable 53.2% 44.3% 36.7% 33.6% 26.6%
Partially Favorable 6.4% 5.2% 2.8% 3.1% 1.8%
Unfavorable 27.9% 25.5% 30.1% 37.5% 43.5%
Dismissed 12.5% 25.0% 30.4% 25.8% 28.1%

  

 

Claims FY12 FY13 FY14 FY15
 
FY16
(Data through March 2016)
Fully Favorable 33.8% 35.1% 28.4% 18.4% 6.6%
Partially Favorable 16.4% 11.6% 11.5% 6.2% 1.9%
Unfavorable 34.1% 28.6% 31.4% 23.2% 11.6%
Dismissed 15.7% 24.7% 28.7% 52.2% 79.9%
*Includes appeals decided in the listed fiscal year
**Run Date: Apr 18, 2016

 

Average Processing Time By Fiscal Year

Fiscal Year Number of Days
FY09 94.9
FY10 109.6
FY11 121.3
FY12 134.5
FY13 220.7
FY14 414.8 
FY15 661.1
FY16 Average 819.4
1st Qtr 795.8
2nd Qtr 860.6

Content last reviewed on May 4, 2016