Judge Requests Hospital Input on How to Solve ALJ Backlog

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 An appeals court last August rescinded the court’s earlier order but left the lower court free to reinstate the same requirement if HHS fails to demonstrate it is “impossible” to comply.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.