’WPC  |kłS©4¾÷3 „En’„…(Ū&ÆįDX.„4®†yµń„2Ź“ćc°2dZKå ¦l¬ĪAšÄ‰Ŗ†2ņ3æ½½ŚqśUóå¼MįiÜQQq†wżźÆĘ50L–½YŠĶāiž6ŽL&q$&Óy˜M˜Ž²l„Ę9~°½Ņ(Ō‹ õˆĄ,€gĖµ¾YCźE2P_HiŲÉjD~$h;‡Ś@ŒŒ’3µšVóh—y!ŚCŻłvįć °¼|K¾ć×} 3XÆ—GĆ»‹×żÕ÷ „7.ž «¼‚ Mƒ0&u"{ónoC„Yč“Ij2(}JŪCŗ·y®t†ł¦»ŽįP:SĄ4§°.;¬5)5Ó~^6ōŹ ZÕ¹[>Ū@Žg'1`ĀŌw€öO‰žĆż§.@› Ūąō-µK62ģõ[Ąģ©#śŲæÆx žŽĆfĖÕmļŖC<\ĢÓŁhy‰8:1¼EtĮµ6É`¢ķyš«I·Äļ*,ƖŅ%©~X §fÖĢ=~Ī5Š9É2ū’Ր;źĶ/9:é{°Ē$·GĶ2·6ž,ßxćŚ¢h·‰ūmu¹_ĻT‘Ć Ś_{üÄ/Éā~8o‚Šć„©X#!ŠU Nń %? 0(E 1um^ āwī4ž ! m# # # # # # # # # # # # # # # # # # # # # B: : : : : : : : fW aY Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Cm m m m m m m m m m m m m m m m m m m m m m 0 c‡ ‡ ‡ ‡ ‡ ‡ ‡ C ź ˜HP LaserJet 5Si,ä,,,,,ä0(ČhH  Z‹6Times New Roman RegularX($””3#37=CIQYag­­1.a.i.(1)(a)(i)1)a)q—z,cE%r6)ź:i¢Ų+003|x ’U‹’ĄĄĄ d4’TABLE D’’’’’d(;3£$““Ō2#ŌŚ  Ś0Ś  Ś.Ō3  Ōą0  ą ’’’dŻ ƒ!ŻŻ  ŻńńŌ‡&tż%XXŌńńńńńńĢŠ  ŒÜ ŠĢĢńńńńńńŌ#†X|ŖX%&tż #ŌŌ‡¼hÅ»XX|ŖŌńńńńńńą@w w ģąńńńńńńDEPARTMENTAL€APPEALS€BOARDŌ#†X|ŖX»¼hŘ#ŌŌ‡&tż%XX|ŖŌŠ ° ŠĢą@ģąPERFORMANCE€PLAN€FOR€FY€2003ˆĢĢThe€Departmental€Appeals€Board€(DAB)€is€an€independent€office€established€to€provide€conflictĻresolution€services.€€These€services€are€basically€of€two€types:€1)€adjudicatory€hearings,€appellate€reviewĻof€decisions€of€Administrative€Law€Judges€(ALJs),€and€similarly€structured€formal€and€informal€reviewsĻof€contested€decisions;€and€2)€alternative€dispute€resolution€(ADR),€including€mediation€and€otherĻconsensual€processes€and€training€related€to€ADR.€€ĢĢOrganizationally,€DAB€has€four€Divisions:ĢĢŻ ‚P3£ ŻŻ  ŻŻ‚P3£~ŻŌ2#ŌŚ  Ś1Ś  Ś.Ō3  Ōą0  ąŻ  ŻņņThe€Appellate€Divisionóó€supports€the€Board€Members,€issuing€decisions€on€behalf€of€the€SecretaryŠ <Œ  Šof€HHS€in€a€wide€variety€of€cases.€€In€some€cases,€the€Board€provides€a€hearing€if€one€is€needed;Ļin€others,€the€Board€provides€an€appellate„type€review.€€ŻƒP3£~©ŻŒŠ (#(# ŠŒŻ  ŻĢŻ ‚P3£ ŻŻ  ŻŻ‚P3£SŻŌ2#ŌŚ  Ś2Ś  Ś.Ō3  Ōą0  ąŻ  ŻņņThe€Civil€Remedies€Divisionóó€supports€ALJs€who€conduct€hearings€and€issue€initial€decisions€inŠ ¬ü  Šhealth€care€fraud€and€abuse€cases,€provider€sanction€cases,€and€other€civil€enforcement€cases.€€ŻƒP3£S~ŻŒŠ (#(# ŠŒŻ  ŻĢŻ ‚P3£ ŻŻ  ŻŻ‚P3£ėŻŌ2#ŌŚ  Ś3Ś  Ś.Ō3  Ōą0  ąŻ  ŻņņThe€Medicare€Operations€Divisionóó€supports€Administrative€Appeals€Judges€(AAJs)€who€act€asŠ @ Šthe€Medicare€Appeals€Council€for€review€of€decisions€by€SSA€ALJs€in€Medicare€entitlement€andĻcoverage€cases€(i.e.,€Medicare€Appeals).€€ŻƒP3£ėŻŒŠ (#(# ŠŒŻ  ŻĢNOTE:€€The€Board€Members€and€other€judges€are€part€of€the€Immediate€Office€of€the€Chair€of€the€BoardĻ(together€with€administrative€support€staff),€but€are€considered€part€of€the€Divisions€for€purposes€ofĻGPRA,€since€their€caseloads€are€identified€to€the€Divisions.ĢĢŻ ‚P3£ ŻŻ  ŻŻ‚P3£° ŻŌ2#ŌŚ  Ś4Ś  Ś.Ō3  Ōą0  ąŻ  ŻņņThe€Alternative€Dispute€Resolution€(ADR)€Divisionóó€supports€the€Chair€of€the€Board€in€herŠ  p Šfunction€as€Dispute€Resolution€Specialist€for€the€Department,€providing€overall€leadership€forĻADR€at€HHS.€€The€Division€also€provides€some€direct€ADR€services,€such€as€mediation€in€BoardĻcases€and€other€Department€disputes€and€providing€ADR€training.ŻƒP3£° Ū ŻŒŠ (#(# ŠŒŻ  ŻĢThe€DAB€has€no€control€over€its€caseload.€€Since€the€mid„1990's,€caseload€sizes€have€grown€veryĻrapidly,€particularly€for€the€Civil€Remedies€and€Medicare€Operations€Divisions.€€Caseload€projectionsĻsignal€continued€growth.€€In€addition,€cases€are€increasing€in€complexity,€thereby€requiring€more€time€forĻanalysis€and€decision„making.€Finally,€the€use€of€ADR€is€expanding€š!š€€requests€for€mediation€servicesĻhave€more€than€doubled€over€the€past€three€years.€€The€Performance€Goals€support€and€respond€to€otherĻefforts€(e.g.,€work€redesign,€improved€data€collection,€increased€staffing)€to€effectively€carry€out€DABššsĻresponsibilities€and€functions.ĢŠ  p&Ą!' ŠŌ#†X|ŖX%&tż$#ŌŌ‡&tż%XX|ŖŌŌ*‹ƒ( )ddd Xdd Xdd X°(#°(#‹ŌŌ," dd ŌŌ,ždd ŌŌ,ždd ŌŌ,dd ŌŌ+  ŌŠ /€: ° €€„„/ŠĢPerformance€GoalsŠ A€:,!š@": „„AŠĢFY€TargetsŠ A€:,!š@": „„AŠActualĢPerformanceŠ A€:,!š@": „„AŠĢReference*Š =€W(&š@"  : =ŠGoal€1.ĢMaintain€Appellate€Division€caseĻprocessing€rates.ĢĢMeasure:€€Percentage€of€decisionsĻwith€net€case€age€of€six€months€orĻless.Š $ˆ ŲW $ŠĢĢFY€03:€70%ĢFY€02:€70%ĢFY€01:€70%€€€€€€€€€€€€€€€ĻFY€00:€60%ĢFY€99:€80%€Š  ˆ Ų ŠĢĢĢFY€02:ĢFY€01:€75%ĢFY€00:€81%ĢFY€99:€53%Š  ˆ Ų „„ŠŠ )€W`°" )ŠGoal€2.ĢMaintain€Appellate€DivisionĻreversal€and€remand€rate€of€BoardĻdecisions€appealed€to€federalĻcourts.ĢĢMeasure:€number€of€decisionsĻreversed€or€remanded€on€appeal€toĻfederal€court€as€a€percentage€of€allĻBoard€decisions€issued.Š $“(W $ŠĢĢĢĢĢFY€03:€2%ĢFY€02:€2%ĢFY€01:€2%ĢFY€00:€2%ĢFY€99:€2%Š  “2 ŠĢĢĢĢĢĢFY€02:ĢFY€01:€2%ĢFY€00:€2%ĢFY€99:€2%Š  “< „„ŠŠ )€Wų H =" )ŠGoal€3.€ĢMaintain€annual€output€of€CivilĻRemedies€Division€decisions€perĻALJ€year.ĢĢMeasure:€€number€of€decisionsĻannually€per€ALJ€year€(revised)ĢĢGoal€3€(new)ĢIncrease€Civil€Remedies€caseĻprocessing€rates€for€InspectorĻGeneral€cases.ĢĢMeasure:€percentage€of€decisionsĻissued€within€60€days€of€the€closeĻof€the€record.Š $$XMW $ŠĢĢFY€03:€N/AĢFY€02:€N/AĢFY€01:€N/AĢFY€00:€10€per€ALJĻyear.€€ĢFY€99:€55ĢĢĢĢĢFY€03:€80%ĢFY€02:€80%ĢFY€01:€(new€goal)Š  ,#|\ ŠĢĢĢĢFY€01:€N/AĢFY€00:€13ĢĢFY€99:€69€*€(seeĻnarrative)ĢĢĢĢĢĢFY€01:€78%€(baseline)Š  ,#|k „„ŠŠ )€W$tl" )ŠGoal€4.ĢReduce€average€net€case€age€forĻCivil€Remedies€Division€decisions.ĢĢMeasure:€average€net€days€forĻcases€from€receipt€to€decision€inĻtarget€year€compared€to€FY€99.ĢŠ $|+Ģ&tW $ŠĢFY€03:€15%ĢFY€02:€15%€ĢFY€01:€15%€ĢĢFY€00:€10%€reductionĢĢFY€99:€N/AŠ  |+Ģ&| ŠĢĢFY€02:ĢFY€01:€559€days€(37%Ļincrease)ĢFY€00:€406€days€(22%Ļincrease)ĢFY€99:€332€daysĻ(baseline)Š  X,Ø'… „„Šā āŠ )€Wx%Č †" )ŠGoal€5.Ģā āIncrease€use€of€ADR€(i.e.,Ļmediation)€in€appealed€cases.ĢĢMeasure:€€number€of€casesĻmediated€in€FY€2003€comparedĻwith€number€of€cases€mediated€inĻFY€2002.Š $d hW $ŠĢFY€03:€10%€increaseĻover€FY€2002ĢFY€02:€10%€increaseĻover€FY€2001ĢFY€01:€10%€increaseĻover€FY€2000ĢFY€00:€25%€increaseĻover€FY€99ĢFY€99:€25%€increaseŠ    ŠĢĢĢFY€02:ĢĢFY€01:€34€(14%Ļincrease)ĢFY€00:€29€for€a€€26%Ļincrease.ĢFY€99:€62€(23€used€forĻmeasurement€purposesĻfor€a€28€%€increase)ĢFY€98:€18€casesĻ(baseline)Š  Œ  „„ŠŠ )€W`d!" )ŠGoal€6.ĢExpand€ADR€trainingĻopportunities.ĢĢMeasure€1:€€number€of€sessionsĻoffered.ĢĢĢĢMeasure€2:€number€of€HHS€staffĻtrained.Š $”˜,W $ŠĢĢFY€03:€€12ĢFY€02:€€12ĢFY€01:€€12ĢFY€00:€€€9€sessionsĢFY€99:€€€6€sessionsĢĢFY€03:€400ĢFY€02:€400ĢFY€01:€400ĢFY€00:€400ĢFY€99:€200€Š  LP9 Š€ĢĢĢFY€02:ĢFY€01:€€14ĢFY€00:€€15ĢFY€99:€€12ĢĢFY€02:ĢFY€01:€409ĢFY€00:€435ĢFY€99:€400ĢFY€98:€150€(baseline)Š  LPF „„ŠŠ )€Wü G" )ŠGoal€7:ĢEncourage€use€of€ADR€in€allĻOPDIVs,€including€OS.ĢĢMeasure€1:€number€of€meetingsĻand/or€presentations€withĻmanagement€and€others,€includingĻfederal€interagency€efforts,€toĻfoster€application€of€ADRĻtechniques.ĢĢMeasure€2:€number€of€HHS€casesĻmediated€through€Sharing€Neutrals.Š $ *#TW $ŠĢĢĢFY€03:€€15ĢFY€02:€€15€ĢFY€01:€€15ĢFY€00:€€15ĢFY€99:€N/AĢĢFY€03:€36ĢFY€02:€34ĢFY€01:€30Š  0)4"` ŠĢĢĢĢFY€02:ĢFY€01:€18ĢFY€00:€15ĢFY€99:€12€(baseline)ĢĢĢFY€02:ĢFY€01:€30ĢFY€00:€28€(baseline)Š   *#m „„Šā āŠ )€W¼Ąn" )ŠGoal€8:ĢReduce€average€time€to€completeĻaction€on€Medicare€Appeals€beforeĻā āthe€Medicare€Appeals€Council.ĢĢMeasure:€average€time€to€completeĻaction€on€Medicare€Appeals€cases.ĢĢGoal€8€(Revised)ĢConstrain€growth€in€average€timeĻto€complete€action€on€MedicareĻAppeals€cases.€€(See€rationaleĻbelow)ĢĢMeasure:€average€time€to€completeĻaction€on€Medicare€Appeals€cases.€Š $DH W $ŠĢĢĢĢFY€01:€N/AĢFY€00:€12€monthsĢFY€99:€€€6€monthsĢĢĢĢFY€03:€18€monthsĢFY€02:€16€monthsĢFY€01:€€21€monthsŠ  °“  ŠĢĢĢĢFY€01:€N/AĢFY€00:€15€monthsĢFY€99:€20€monthsĢĢĢĢĢFY€02:ĢFY€01:€14.2€monthsĢFY€00:15€monthsĢFY€99:20€monthsĻ(baseline)Š  DH - „„ŠŠ )€W`d." )ŠGoal€9:ĢReduce€percentage€of€MedicareĻAppeals€cases€that€exceed€theĻaction€target.ĢĢMeasure:€percentage€of€cases€inĻpending€workload€that€exceed€the€Ļtarget€ĢĢGoal€9€(Revised)ĢIncrease€number€of€dispositions€ofĻMedicare€Appeals€cases.€€(SeeĻrationale€below).ĢĢMeasure:€Number€of€dispositions.Š $¼!Ą=W $ŠĢĢĢĢĢFY€01:€N/AĢFY€00:€50%ĢFY€99:€N/AĢĢĢFY€03:€5,500ĢFY€02:€5,250€casesĢFY€01:€5,000€casesĢĢŠ  ¼!ĄL ŠĢĢĢĢĢFY€01:ĢFY€00:€52%ĢFY€99:€72%€(baseline)ĢĢĢĢFY€02:ĢFY€01:€7,955ĢFY€00:€4,435Ļ(baseline)Š  ¼!Ą[ „„ŠŠ )€W“ø\" )ŠGoal€10:€(Dropped€as€DAB€goal)ĢDevelop€program„specificĻregulations€governing€review€ofĻALJ€decisions€concerningĻMedicare€claims.ĢĢThis€is€no€longer€a€relevant€goal€forĻDAB€as€this€is€a€HCFA€initiative.€€Š $0)4"dW $ŠĢĢFY€01:€N/AĢFY€00:€N/AĢFY€99:€DevelopĻregulationŠ  x'| j ŠĢĢĢĢFY€99:€HCFAĻestablishes€workgroup€Ģ€€€Š  T(X!q „„Šā āŠ )€W,#0r" )ŠGoal€11:€Increase€MedicareĻOperations€staff€effectivenessĻthrough€training.ĢĢā āMeasure:€percentage€of€staffĻtrained.ĢŠ $ˆ ŒW $ŠĢĢFY€03:€100%ĢFY€02:€100%ĢFY€01:€100%ĢFY€00:€100%ĢFY€99:€N/AŠ  ˆ Œ ŠĢĢĢĢFY€01:€100%ĢFY€00:€100%ĢFY€99:€80%€(baseline)Š  ˆ Œ „„ŠŠ"`d" "ŠŌ#†X<åX%&4«i#ŌŌ‡&4«%XX<åŌĢĢņņGoal€1:€€Maintain€Appellate€Division€case€processing€ratesóóŠ LP ŠĢMeasure:€percentage€of€decisions€with€a€net€case€age€of€six€months€or€less.€€ĢĢņņEstablishing€Performance€Targetsóó:€€The€Appellate€Division€reviews€1)€determinations€appealed€directlyŠ ¼Ą  Što€the€Board€in€a€wide€range€of€cases,€including€disallowances€under€discretionary€and€mandatory€grantĻprograms,€disapprovals€of€cost€allocation€plans,€unilateral€determinations€of€indirect€cost€rates,Ļterminations€of€Head€Start€and€other€discretionary€grants,€sanctions€in€research€misconduct€cases,€andĻdeterminations€of€ineligibility€for€ANA€grants;€and€2)€appeals€by€either€party€of€ALJ€decisions€in€casesĻheard€by€the€Civil€Remedies€Division,€decisions€by€FDA€ALJs,€and€decisions€by€ALJs€in€the€DepartmentĻof€the€Interior€in€cases€involving€the€Indian€Health€Serviceššs€declination€of€proposed€Indian€Self„¼Determination€Act€contracts.€ĢĢThis€goal€addresses€the€timeliness€of€case€review€and€decisions€issued.€€The€Performance€Target€for€FYĻ2001€was€70%.€€Although€the€Appellate€Division€exceeded€this€goal,€the€Division€is€unlikely€to€maintainĻthe€higher€level€of€case€processing€rates,€due€to€a€€projected€growth€in€the€caseload.€€As€a€result,€theĻperformance€targets€are€maintained€at€70%€for€FY€2002€and€FY2003.€ĢĢņņPerformance€Progress:óó€€N/AŠ ÄČ* ŠĢņņGoal€2:€€Maintain€the€Appellate€Divisionššs€reversal€and€remand€rate€on€Board€decisions€appealed€toŠ | €, ŠFederal€courts.óóŠ X!\- ŠĢMeasure:€Number€of€decisions€reversed€or€remanded€on€appeal€to€Federal€court,€as€a€percentage€of€allĻBoard€decisions€issued€(1,789€decisions€by€the€end€of€FY€2001).ĢĢEstablishing€Performance€Targets:€This€goal€addresses€the€quality€of€Board€decisions.€€Historically,€2%Ļor€less€of€all€Board€decisions€have€been€reversed€or€remanded€on€appeal€to€Federal€court.€€A€performanceĻtarget€of€2%€was€established€for€FY€2001,€and€continues€for€FY2002€and€FY€2003.ĢĢņņPerformance€Progress:€óó€The€performance€target€for€FY€2001€was€met.Š )"6 ŠĢņņGoal€3:€€Maintain€annual€output€of€ALJ€decisionsóó.€(replaced€by€revised€Goal€3€below)Š Ģ*Š#8 ŠĢMeasure:€Total€number€of€decisions€in€FY1999.ĢRevised€Measure:€Number€of€decisions€annually€per€ALJ€year.Š `-d&; Š‡ņņEstablishing€Performance€Targets:óó€€The€original€target€was€based€on€an€annual€number€of€decisions€overŠ ° Štime€in€a€fairly€stable€environment.€€The€measure€was€changed€to€reflect€the€large€increase€in€caseload,Ļgrowing€backlogs,€and€the€addition€of€ALJs.€€Cases€that€go€to€decision€are€generally€complex,€involve€aĻlarge€record€and€an€in„person€hearing€that€can€last€up€to€a€week,€and€require€considerable€time€to€decide.€ĻIn€addition,€although€the€majority€of€cases€before€the€ALJs€are€settled,€withdrawn,€or€otherwiseĻdismissed,€€they€still€require€judicial€time€at€the€pre„decisional€phase.€ņņ€óóWith€these€factors€in€mind,€theŠ üL Šmeasure€identified€a€target€number€of€decisions€per€ALJ€year,€rather€than€a€total€number.€(ņņNoteóó:€resultsŠ Ų ( Šfor€FY€1999€reported€the€ņņtotalóó€number€of€decisions).€€The€target€for€FY€2000€was€10€decisions€for€eachŠ “  ŠALJ€year.ĢĢDAB€replaced€this€goal€for€FY€2001.€€The€goal€is€inappropriate,€as€output€quotas€cannot,€by€law,€beĻestablished€for€ALJs.ĢĢņņPerformance€Progress:€óó€N/AŠ Ü,  ŠĢņņGoal€3€(new€for€FY€2002):€€Increase€Civil€Remedies€Division€case€processing€rates€for€Inspector€GeneralŠ ”ä  Š(IG)€cases.óóŠ pĄ  ŠĢMeasure:€Percentage€of€decisions€within€60€days€of€the€close€of€the€record.ĢĢņņEstablishing€Performance€Targets:€óóAccording€to€regulations,€decisions€on€IG€cases€are€to€be€madeŠ ą0 Šwithin€60€days€of€the€close€of€the€record.€€In€actuality,€that€deadline€is€sometimes€exceeded.€€This€goalĻfocuses€on€tracking€and€increasing€the€percentage€of€cases€decided€within€60€daysņņ.€€óóThe€target€for€FYŠ ˜č Š2002€is€80%€of€decisions€made€within€60€days€of€the€close€of€the€record.€€This€target€continues€for€FYĻ2003.ĢĢņņGoal€4:€€Reduce€average€net€case€age€of€Civil€Remedies€Division€decisions.Š X ŠĢóóMeasure:€Average€net€case€age€for€cases€to€move€from€receipt€to€decision.Š Ą ŠĢņņEstablishing€Performance€Targets:€óóThis€goal€addresses€timeliness.€€The€target€for€FY€2000,€the€first€yearŠ xČ Šfor€this€goal,€was€a€10%€reduction€in€the€average€net€case€age€for€cases€requiring€a€written€decision.€€AĻtarget€of€15%€was€set€for€FY€2001,€and€continues€for€€FY€2002€and€FY2003.ĢĢņņPerformance€Progress:óó€The€Civil€Remedies€Division€did€not€meet€its€goal€of€reducing€the€average€caseŠ č!8" Šage€by€15%€in€FY€2001,€because€the€Division€lost€three€experienced€ALJs€in€January€and€February€ofĻ2001.€€Although€the€Division€replaced€one€ALJ€in€May,€there€is€an€initial€learning€curve€which€depressesĻproductivity.€€In€addition,€the€Division€lost€several€support€staff€who€would€have€been€available€to€writeĻdecisions€and€assist€in€monitoring€cases.ĢĢņņGoal€5:€€Increase€the€use€of€Alternative€Dispute€Resolution€(ADR)€in€appealed€cases.Š '`"( ŠĢóóņņEstablishing€Performance€Targets:óó€€This€goal€is€directed€at€expanding€the€use€of€ADR€(i.e.,€mediation)Š Č($* Šin€cases€appealed€to€the€DAB.€€Mediation,€when€successful,€can€resolve€appeals€faster€and€lessĻexpensively€than€the€formal€appeal€process.€€Greater€use€of€mediation€also€has€the€potential€for€reducingĻcase€backlogs.€€The€target€for€FY€1999€was€a€25%€increase€in€the€number€of€appealed€cases€mediatedĻcompared€to€FY€1998.ĢĢIn€FY€1999,€63€cases€were€mediated;€however,€40€of€these€cases€represent€a€one„time€appeal€of€a€blockŠ š-@)0 Šof€cases€involving€a€unique€cost€allocation€issue.€€For€performance€measurement€purposes€over€time,ĻDAB€proposes€to€factor€out€this€block,€leaving€a€total€of€23€cases€mediated.€€An€additional€increase€ofĻ25%€was€targeted€for€FY€2000;€the€target€for€FY€2001€was€a€10%€increase€over€FY€2000.€€This€same€rateĻof€increase€is€targeted€for€FY€2002€and€FY€2003.ĢĢņņPerformance€Progress:óó€Thirty€cases€were€mediated€in€FY€2001,€for€a€14%€€increase€over€FY2000,€thusŠ üL Šexceeding€the€goal.€ĢĢņņGoal€6:€€Expand€ADR€training€opportunities.óóŠ  ą ŠĢMeasure€1:€€Number€of€training€sessions€offered.ĢMeasure€2:€€Number€of€HHS€staff€trained.ĢņņĢEstablishing€Performance€Targets:óó€€Increased€use€of€ADR€is€the€result€of€several€factors:€€increasing€theŠ Ü,  Šawareness€of€alternatives€to€the€typical€ways€of€dealing€with€conflict;€understanding€ADR€processes€andĻtheir€potential€use;€and€expanding€the€availability€of€trained€neutrals.€€Identified€measures€address€bothĻthe€availability€of€training€and€the€number€of€staff€trained.€€ĢĢThe€target€for€Measure€1,€number€of€sessions€conducted,€was€12€for€€FY€2001.€€This€target€continues€forĻFY€2002€and€FY€2003.€€The€Measure€2€target€for€FY€2001€was€400€staff€trained;€it€continues€for€FYĻ2002€and€FY€2003.ĢĢņņPerformance€Progress:óóŠ ˜č ŠMeasure€1:€14€sessions€were€held€in€€FY€2001,€exceeding€the€target€of€12.€ĢĢMeasure€2:€409€staff€€were€trained€in€FY€2001,€exceeding€the€target€of€400.€€ĢĢņņGoal€7:€€Encourage€the€use€of€ADR€in€all€Operating€Divisions.óóŠ ä4 ŠĢMeasure€1:€Number€of€meetings€and/or€presentations€with€management€and€others,€including€FederalĻinteragency€efforts,€to€foster€the€application€of€ADR€techniques.ĢĢMeasure€2:€Number€of€HHS€cases€mediated€through€Sharing€Neutrals.€ĢĢņņEstablishing€Performance€Targets:óó€This€goal€supports€the€functions€of€the€Departmentššs€DisputeŠ č!8" ŠResolution€Specialist;€the€Chair€of€DAB€is€designated€as€such€by€the€Secretary.€€€€ĢĢMeasure€1:€€Performance€target€for€FY€2001€was€15€sessions;€this€target€continues€for€FY€2002€and€FYĻ2003.ĢĢMeasure€2:€This€measure,€new€in€FY€2001,€reflects€the€increasing€demand€for€low„cost,€qualifiedĻmediators€and€the€role€of€Sharing€Neutrals€in€meeting€this€demand.€€Sharing€Neutrals€is€administered€byĻthe€ADR€division.€€FY€2000€serves€as€the€baseline;€in€that€year,€28€disputes€(in€five€OPDIVs€and€OS)Ļwere€mediated€through€Sharing€Neutrals.€€The€FY€2001€target€was€30€cases€mediated;€34€cases€is€theĻtarget€for€FY€2002,€increasing€to€36€cases€mediated€for€FY€2003.€ĢņņĢPerformance€Progress:€óóŠ 8,ˆ'. ŠMeasure€1:€The€FY€2001€target€was€exceeded,€in€large€part€because€of€the€ADR€Divisionššs€leadershipĻrole€in€initiatives€sponsored€by€DOJ€and€ABA€to€clarify€confidentiality€protections€under€the€ADR€ActŠ š-@)0 Šand€best€practices€in€the€Federal€sectorššs€ADR€proceedings.ĢĢMeasure€2:€The€FY€2001€target€was€met.ĢĢņņGoal€8€(Revised):€€Constrain€growth€in€the€average€time€to€complete€action€on€Medicare€Appeals€beforeŠ  p Šthe€Medicare€Appeals€Council.ĢĢóóMeasure:€Average€time€to€complete€action€on€Medicare€Appeals€casesŠ “  ŠņņĢEstablishing€Performance€Targets:óó€€The€original€goal€(to€reduce€the€average€time€to€complete€action€onŠ l ¼  Šrequests€for€review€before€the€Medicare€Appeals€Council)€was€based€on€the€assumption€that€theĻMedicare€Operations€Division€(MOD)€would€be€fully€staffed,€and€that€the€number€of€incoming€casesĻwould€remain€relatively€stable.€€For€the€following€reasons,€this€became€an€unrealistic€target:€a€static€orĻdecreasing€number€of€staff;€an€increase€in€the€number€of€cases€received€(from€2,262€in€FY€1998€to€7,237Ļin€FY€2000,€7,931€in€FY€2001,€and€a€projected€9,015€in€FY€2002);€increased€complexity€of€cases;€and€anĻincrease€in€the€number€of€civil€actions€filed.€€As€a€result,€the€target€goal€was€revised€to€š šconstrain€theĻgrowth€in€the€average€time.ššĢĢThe€target€was€21€months€for€FY€2001€and€24€months€for€FY2002€and€FY2003.€€The€targets€forĻFY2002€and€FY2003€have€now€been€revised€downward€to€16€months€for€FY2002€and€18€months€forĻFY2003,€to€reflect€new€information.€€The€targets€now€assume€that€implementation€of€the€BenefitsĻImprovement€Protection€Act€(BIPA)€will€be€delayed;€therefore,€MOD€will€not€have€to€give€priority€toĻBIPA€deadline€cases€or€devote€resources€to€processing€cases€for€court,€and€the€backlog€will€not€age€asĻrapidly€as€previously€thought.€€Nevertheless,€the€average€time€to€complete€action€on€a€case€will€increaseĻeach€year€that€MOD€does€not€have€sufficient€resources€to€close€cases€on€a€current€basis,€as€is€reflected€inĻthe€increase€from€FY€2002€to€FY2003.€€If€implementation€of€BIPA€is€ņņnotóó€delayed,€MOD€may€not€beŠ ,| Šable€to€meet€the€FY2002€and€FY2003€goals.€ĢĢņņPerformance€Progress:óó€€In€FY€2001,€the€average€number€of€months€to€complete€action€on€MedicareŠ Ą ŠAppeals€decreased€€to€14.2€months,€exceeding€the€goal€by€6.8€months.€€This€was€due€to€continuedĻprogress€toward€full€implementation€of€MOD€redesign,€and€lower€than€projected€intake€of€cases.€ĢĢņņGoal€9€(Revised):€Increase€Number€of€Dispositions.óóŠ 0 €  ŠĢMeasure:€Number€of€dispositions€ĢĢņņEstablishing€Performance€Targetsóó:€As€with€Goal€8,€the€original€Goal€9€„„€to€reduce€the€age€of€MedicareŠ  #š$ ŠAppeals€cases€by€measuring€the€percentage€of€appeals€exceeding€the€action€target€„„€was€based€on€theĻassumptions€that€the€Medicare€Operations€Division€(MOD)€would€be€fully€staffed,€and€that€the€numberĻof€incoming€cases€would€remain€relatively€stable.€€However,€due€to€a€dramatically€increased€number€ofĻnewly„filed€appeals,€the€goal€to€reduce€the€percentage€of€pending€cases€exceeding€€processing€timeĻtargets€diminished€in€value€as€a€workload€measure.€€€The€number€of€cases€filed€in€FY€2000€increased€byĻ80%€to€7,237,€with€a€year„end€pending€caseload€of€11,500.€€Based€on€this€analysis,€the€target€goal€wasĻrevised€to€increase€the€number€of€dispositions€for€FY€2001€(5,000€dispositions)€and€FY€2002€(5,250).€€ByĻincreasing€the€number€of€dispositions,€the€growth€in€the€average€case€age€may€also€be€constrained.€€ĢĢMOD€case€processing€has€been€evaluated,€and€recommendations€are€now€being€implemented.€€Moreover,ĻMOD€was€finally€able€to€fill€vacant€clerical€positions€in€FY€2001,€and€two€new€FTE€are€to€be€added€inĻthe€last€half€of€FY2002.€€As€a€result,€DAB€is€projecting€an€increase€to€5,250€dispositions€in€FY€2002€andŠ š-@)0 Š5,500€in€FY2003,€when€the€two€new€positions€become€fully€productive.€€€ĢņņĢMeasuring€Performance:€óó€FY€2000€serves€as€the€baseline.Š hø ŠĢņņPerformance€Progress:€Performance€Progressóó:€The€actual€number€of€dispositions€in€FY2001€(7,955)Š  p Šexceeded€projections€(5,000).€€This€was€due€to€continued€implementation€of€MODššs€reinvented€caseĻprocessing€procedures,€plus€an€unusually€large€number€of€remands€(roughly€2,000)€resulting€from€theĻunavailability€of€hearing€records€and/or€claim€files€from€SSA€ALJs.€ĢĢņņGoal€10:€€Develop€program„specific€regulations€governing€review€of€ALJ€decisions€concerning€MedicareŠ l ¼  Šclaims.óó€€(This€goal€has€been€dropped).Š H ˜  ŠĢDAB€has€dropped€this€goal€for€performance€measurement€purposes,€although€DAB€continues€to€believeĻthat€the€hearings€and€appeals€process€needs€improvement.€€DAB€has€participated€on€a€CMS€work€groupĻestablished€to€address€this€and€related€issues.ĢĢņņGoal€11:€€Increase€the€effectiveness€of€MOD€staff€through€training.Š pĄ  ŠĢóóMeasure:€Percentage€of€staff€trained€in€at€least€two€substantive€areas.€€This€is€a€revised€measure,€usingŠ (x Špercentages€rather€than€numbers.€€Since€the€number€of€staff€has€fluctuated,€DAB€believes€percentagesĻwill€be€a€more€effective€measure.ĢĢņņEstablishing€Performance€Targets:€óó€FY€1999€served€as€the€baseline.€€DAB€determined€the€number€ofŠ ˜č Šstaff€who€attended€training€sessions€(12)€as€a€percentage€of€total€staff€(15),€or€80%.€€Because€of€aĻrevamped€tracking€system€and€other€organizational€changes,€a€target€of€100%€was€set€for€FY2000€andĻFY€2001.€€This€target€continues€for€FY€2002€and€FY€2003.ĢĢņņPerformance€Progress:€óó100%€of€staff€received€training€in€FY€2001.Š ä4 ŠĢņņData€Verification€and€ValidityóóŠ œģ ŠĢCase€data€are€entered€in€controlled„access€databases,€with€case„specific€identification.€€Other€programĻdata€(e.g.,€number€of€training€sessions,€number€of€cases€reversed€or€remanded)€are€also€recorded€andĻtracked.€€Data€used€in€performance€measures€are€validated€by€generating€periodic€reports.€€At€the€end€ofĻthe€fiscal€year,€the€report€totals€will€be€cross„checked€with€annual€totals€for€each€measure.Ō#†X<åX%&4«™'#Ōńń