HHS cuts Medicare appeals backlog 25%, exceeds court-ordered target

HHS is ahead of schedule for reducing the backlog of Medicare appeals at the administrative law judge level, according to a recent status report obtained by the American Hospital Association.

By June 30, the end of this year's third fiscal quarter, the department had cut the backlog by 25 percent, it told a federal court.

"There has been a net reduction of 108,340 appeals pending at OMHA [Office of Medicare Hearings and Appeals] with a total of 318,254 appeals pending at OMHA by the end of the third quarter, which is a 25.4 percent reduction from the starting number of appeals identified in the court's Nov. 1, 2018 order (426,594 appeals)," HHS reported.

The HHS status report was part of a federal judge's ruling in a lawsuit filed by the American Hospital Association; Mountain Home, Ark.-based Baxter Regional Medical Center; Knoxville, Tenn.-based Covenant Health; and Rutland (Vt.) Regional Medical Center.

Last November, U.S. District Judge James Boasberg ordered HHS to incrementally reduce the backlog of appeals at the administrative law judge level. He told the department to reduce the backlog by 19 percent by the end of fiscal year 2019; 49 percent by the end of fiscal year 2020; 75 percent by the end of fiscal year 2021; and eliminate it by the end of fiscal year 2022.

The recently reported 25 percent reduction puts HHS ahead of the judge's schedule. Resolutions are the result of more Medicare hearings and appeals settlement conferences, the hospital association said.


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