Medicare Program Integrity Manual (Pub. 100-08), Ch. 3 § 3.9.2

Coordination of the ALJ Hearing

Last amended: 2017Year: 2017Length: 205 wordsOfficial source
3.9.2 - Coordination of the ALJ Hearing (Rev. 748, Issued: 10-13-17; Effective: 11-14-17; Implementation: 11-14-17) As needed, if multiple entities are participating in a hearing as a party, participant, or witness, the QIC will set up a brief pre-hearing conference call to discuss the respective entity’s participation in the case, roles and responsibilities, etc. Examples in which this may be necessary include high dollar cases, extrapolated overpayments, policy implications, and/or fraud related cases, etc. Pre-hearing briefing topics may include: coordination with OMHA on scheduling matters, the manner of participation, coordination on position papers or other written testimony submitted, and lessons learned from participation in the ALJ process. There may be cases in which testimony from another contractor is necessary. The contractor may call those entities as a witness only if the contractor has declared party status. However, if the contractor submits a position paper as a participant, the contractor may collaborate with other contractors and document their views on the case in the paper—although only one contractor may typically participate via the hearing. The contractor shall establish a single point of contact for ALJ offices on administrative matters involving notifications, scheduling, information sharing, and other coordination necessary between the ALJ, the appellant, and other contractors.
Medicare Program Integrity Manual (Pub. 100-08), Ch. 3 § 3.9.2: Coordination of the ALJ Hearing | Justis AI