QIC Telephone Discussion and Reopening Process Demonstration

On January 1, 2016, the Centers for Medicaid & Medicaid Services (CMS) launched the Telephone Discussion and Reopening Process Demonstration (the Demonstration) with Durable Medical Equipment (DME) suppliers that submit Medicare fee-for-service claims.

The Demonstration allowed selected suppliers and providers to participate in a telephone discussion at the Qualified Independent Contractor (QIC) level and have claims currently pending at the Office of Medicare Hearings and Appeals (OMHA) remanded to and reopened by the QIC and resolved.

On May 1, 2019, CMS expanded Demonstration activities to the Part A East QIC Jurisdiction to include:

• All Part A claim types within MAC Jurisdictions: H, J, K, L, M, N.

• Home Health and Hospice (HHH) related appeals in J6 and J15.

 Also, as part of the Demonstration, the DME and Part A East QIC were able to assist suppliers and providers in submitting withdrawals of appeals requests pending at OMHA.

The six-year Demonstration effort ended on December 31, 2021. See the link below in the “Downloads” section for the final Medicare Appeals Demonstration Fact Sheet (2022).