Congress gives HHS $182M to eliminate Medicare appeals backlog by 2022

HHS projects a federal appropriation will allow it to eliminate the Medicare appeals backlog by fiscal year 2022, according to a court brief filed Aug. 3.

The agency published the projection after Congress appropriated $182.3 million to the Office of Medicare Hearings and Appeals. That's up 70 percent from the amount appropriated for 2017.

"Given this appropriation, HHS is now able to project that, with a continuation of current funding levels, [it] will be able to eliminate the backlog entirely in 2022," the agency wrote.

HHS said it plans to use the funds to hire 80 administrative law judges and 600 new staff members in the next 14 months. The agency said taking those steps will allow the Office of Medicare Hearings and Appeals to resolve about 188,000 appeals annually, up from about 85,000 appeals last year.

The Office of Medicare Hearings and Appeals' "adjudication capacity in 2017 was not enough to keep pace with the almost 113,000 new receipts received…in that year," HHS said. However, the agency estimated the Office of Medicare Hearings and Appeals will be able to process "thousands more appeals each year than it receives" thanks to the appropriation. 

The Aug. 3 brief was filed as part of a lawsuit brought by the American Hospital Association and three member facilities. The lawsuit focuses on resolving Medicare claims appeals at the administrative law judge level within 90 days.


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