As a result of AHA lawsuit, HHS continues to reduce appeals backlog

The Department of Health and Human Services through March 26 has reduced by more than 69% its backlog of Medicare appeals at the Administrative Law Judge level, according to a status report the agency provided Friday to a federal court.

“At the end of the first quarter of 2021, a total of 131,961 appeals remained pending at OMHA [Office of Medicare Hearings and Appeals], which is a reduction of over 69% from the starting number of appeals identified in the Court’s order (426,594 appeals),” HHS told the court.

The reduction, which puts the agency ahead of schedule for reducing the backlog, responds to a 2018 federal court ruling 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. It appears that most resolutions are coming from increased OMHA adjudications.