Settlement Conference Facilitation Pilot
Settlement Conference Facilitation is a pilot alternate dispute resolution process designed to bring the appellant and the Centers for Medicare & Medicaid Services (CMS) together to discuss the potential of a mutually agreeable resolution for claims appealed to the Administrative Law Judge hearing level of the Medicare claim appeals process. If a resolution is reached, a settlement document is drafted by the settlement conference facilitator to reflect the agreement and the document is signed by the appellant and CMS at the settlement conference session. As part of the agreement, the requests for an Administrative Law Judge hearing for the claims covered by the settlement will be dismissed.
The settlement conference facilitator uses mediation principles to assist the appellant and CMS in working toward a mutually agreeable resolution. The facilitator does not make official determinations on the merits of the claims at issue and does not serve as a fact finder, but may help the appellant and CMS see the relative strengths and weaknesses of their positions. The settlement conference facilitator is an employee of the Office of Medicare Hearings and Appeals, which is a component of the HHS Office of the Secretary, and is organizationally and functionally separate from CMS.