A federal judge has asked the AHA to provide detailed suggestions on behalf of hospitals and health systems for how the Department of Health and Human Services can reduce the backlog of Medicare billing appeals awaiting adjudication at the Administrative Law Judge level and prevent another huge influx of appeals as a result of inappropriate payment denials. AHA and three member hospitals in February urged the U.S. District Court for the District of Columbia to require the HHS Secretary to clear the Medicare appeals backlog at the ALJ level within five years, as its earlier order in the case had required, saying the agency has failed to show that it cannot meet the requirement. An appeals court last August rescinded the court’s earlier order but left the lower court free to reinstate the same requirement if HHS fails to demonstrate it is “impossible” to comply. AHA initially sued HHS over the backlog in 2012. U.S. District Judge James Boasberg, expressing frustration with HHS’s lack of progress, has requested that AHA elaborate and expand upon on the recommendations it has made over the course of litigation for clearing the backlog by June 22. HHS will have until July 6 to respond.

Related News Articles

Headline
The Centers for Medicare & Medicaid Services yesterday released a fact sheet for state and local governments seeking Medicare, Medicaid or Children’s…
Headline
Over 1,750 Medicare Part D prescription drug plans and Medicare Advantage plans with prescription drug coverage have applied to offer lower insulin costs…
Headline
The Government Accountability Office today named three new members to the Medicare Payment Advisory Commission through April 2023. They are: Wayne…
Headline
More than half of U.S. adults aged 70 and older have experienced a disruption in their medical care during the first month of social distancing for COVID-19,…
Headline
The AHA and other national hospital organizations today urged the Department of Health and Human Services and Centers for Medicare & Medicaid Services to…
Headline
The Medicare Hospital Insurance Trust Fund will have sufficient funds to pay full benefits until 2026, according to the latest annual report from the…