The Office of Medicare Hearings and Appeals (OMHA) has announced the contract award for the next phase of process improvement for the third level of Medicare appeals (Administrative Law Judge or ALJ). On March 30, 2015, CACI Inc. was awarded the development contract for the Electronic Case Adjudication and Processing Environment (ECAPE) for OMHA. This tool is an effort to streamline the procedures of the ALJs after an exponential increase of third level appeals overwhelmed the office and pushed case assignment wait times to nearly two years. This tool will allow the ALJs to process cases electronically, and will feature functionality for...
- Case and workload management,
- Document generation,
- Electronic filing of requests for hearing and supporting documents, and
- Enhanced management information and business intelligence.
The first release will tackle case intake and create an application called the Appellant Public Portal (APP). The first release is anticipated for early 2016. The Appellant Public Portal (APP) is a sub-component of ECAPE. APP will allow appellants to file requests for hearings, submit additional evidence, check appeal status, and view the appeal case file online. There are two separate phases that exist within APP deployment. Phase one of APP will allow a guest user (without registration) to file a request for hearing online, check the status of an appeal and upload the additional relevant evidence to support the case. Phase two of APP will allow users that frequently file appeals to register as a user to file requests for hearing online, upload evidence, check appeal status, view case files, access electronic correspondence, and establish and maintain an appellant profile to expedite repetitive tasks.
The second release of ECAPE is expected in early 2017 and will encompass functionality for the remaining parts of the adjudication process from assignment to case closure.
The third and final release of ECAPE is also scheduled to take place in 2017 to address any enhancements needed to APP as well as other functionality not addressed in the first two releases. This is a major undertaking for the contractor, converting the current labor intensive manual process into an electronic process and streamlining communication channels. Integrating paper documents into an electronic storage and management solution is an extensive process, but is expected to pay dividends for work flow purposes. Ultimately, this new tool will deploy functionality to improve the ALJ appeal process for both appellants and ALJs. OMHA has indicated that additional details will be provided via their listserve as the development of ECAPE progresses.