As a result of AHA lawsuit, HHS making progress in reducing appeals backlog

The Department of Health and Human Services as of July 1 has reduced by nearly 20% its backlog of Medicare appeals at the Administrative Law Judge level, according to a status report the agency recently provided to a federal court.
 
The reduction, which puts the agency ahead of schedule for reducing the backlog, responds to a federal court ruling last year in favor of the AHA and its member hospital plaintiffs that established annual deadline-based targets for reducing the backlog of Medicare appeals at the ALJ level.
 
HHS this month reported that “[f]rom November 1, 2018 through the end of the second quarter of FY 2019, there has been a net reduction of 82,936 appeals pending at OMHA with a total of 343,658 appeals pending at OMHA by the end of the second quarter, which is a 19.4% reduction from the starting number of appeals identified in the Court’s November 1 Order (426,594 appeals).”
 
Last year’s order required that HHS achieve the following reductions from its own currently projected fiscal year 2018 backlog of 426,594 appeals: a 19% reduction by the end of FY 2019; a 49% reduction by the end of FY 2020; a 75% reduction by the end of FY 2021; and elimination of the backlog by the end of FY 2022.