AHA, Hospitals Propose More Ways Court Could Reduce Appeals Backlog

AHA and three member hospitals today recommended to a federal district court four non-deadline remedies to reduce the backlog of Medicare billing appeals awaiting adjudication at the Administrative Law Judge level, while maintaining that the agency has failed to show that it cannot clear the backlog within five years as previously ordered. AHA and the hospitals said four broad categories of non-deadline remedies together would make a “non-trivial dent” in the backlog of appeals: Recovery Audit Contractor controls; settlements; relief from the negative impacts of the backlog; and agency maintenance of effort and periodic status reporting. “The D.C. Circuit remanded to this Court for the Court to decide what is possible to solve the backlog, not a freewheeling inquiry as to what steps HHS would prefer to take to solve the backlog,” they wrote. “Each remedy propose[d] is legal and not futile, and that is all the Court must find to order HHS to carry those steps out.” In April, U.S. District Judge James Boasberg expressed frustration with HHS’s lack of progress and asked AHA and the hospitals for additional input on how to solve the appeals backlog. The brief will be posted later today at https://www.aha.org/legal/litigation.