Court hears oral arguments in AHA challenge of Medicare appeals backlog

AHA and member hospitals yesterday told a federal court that court-ordered targets for reducing the backlog of Medicare appeals at the Administrative Law Judge level remain crucial for ensuring a maintenance of effort by the Department of Health and Human Services. U.S. District Judge James Boasberg focused yesterday’s hearing on deadline-based remedies for addressing the backlog given that the agency’s latest court filings project elimination of the backlog by fiscal year 2022. Government counsel argued that court-ordered reduction targets are now unnecessary because of additional agency funding to expand adjudicatory capacity and the reduced volume of Recovery Audit Contractor-related appeals currently entering the system. An appeals court last year rescinded a court order previously obtained by AHA and the hospitals that required HHS to clear the backlog within five years, but left the district court free to reinstate the same requirement if HHS fails to demonstrate it is “impossible” to comply. Counsel for the AHA and the hospitals urged the court also to consider additional measures to alleviate hardships from the backlogged appeals while further progress is made. Judge Boasberg expects to issue his decision soon.