California hospital sues HHS over Medicare appeals

Casa Colina Hospital and Centers for Healthcare, a rehabilitation hospital based in Pomona, Calif., has filed a lawsuit against HHS requesting the agency resolve Medicare appeals within 90 days of submission as required by federal law.

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The lawsuit was filed May 27 in the U.S. District Court for the Central District of California. In the lawsuit, Casa Colina claims it has been waiting for as long as two years for some of its pending Medicare appeals.

“The lengthy delay in addressing our appeals could threaten our ability to serve the rehabilitation needs of Medicare beneficiaries in California,” said Felice Loverso, PhD, president and CEO of Casa Colina, in a news release.

Casa Colina said most of the claim denials it has appealed have been invalid. In the first quarter of 2015, 73 percent of the claim denials that were appealed by hospitals across the nation were overturned in the appeals process, according to the American Hospital Association’s first-quarter RACTrac survey.

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