Judge asks AHA to weigh in on Medicare appeals backlog: 5 things to know

A federal judge seeks input from hospitals and health systems on how to reduce the Medicare appeals backlog at the Administrative Law Judge level, according to a report from the American Hospital Association.

Here are five things to know.

1. The issue of clearing the appeals backlog was taken up in December 2016. Following a lawsuit filed by AHA and others against HHS, a federal judge ordered HHS to incrementally clear pending appeals by the end of 2020.

2. HHS asked Judge James Boasberg with the U.S. District Court for the District of Columbia to reconsider the order, but that request was denied in January 2017.

3. After HHS appealed the decision, the U.S. Appeals Court for the District of Columbia overturned the order in August 2017, permitting the lower court to decide whether, as HHS contended, it would be impossible to comply with the order's timetable for reducing the backlog.

4. In February 2018, the AHA asked the U.S. District Court for the District of Columbia to reinstate the HHS deadline for clearing the appeals backlog, saying HHS "has not shown it is impossible to clear the backlog — minus, perhaps, some claims with serious program-integrity concerns — within five years."

5. Judge Boasberg has now called on the AHA to "elaborate and expand upon on the recommendations it has made over the course of litigation for clearing the backlog by June 22," according to the AHA. HHS' deadline to respond is in July.

Ayla Ellison contributed to this report. 


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