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

The Department of Health and Human Services through June 30 has reduced by more than 79% its backlog of Medicare appeals at the Administrative Law Judge level, according to a status report the agency provided Tuesday to a federal court.

“By the end of the third quarter of 2021, a total of 86,063 appeals remain pending at OMHA [Office of Medicare Hearings and Appeals], which is a reduction of over 79% from the starting number of appeals identified in the Court’s order (426,594 appeals),” HHS told the court.

The reduction puts the agency ahead of schedule for reducing the backlog in response to a 2018 federal court ruling in favor of the AHA and its member hospital plaintiffs, which established annual deadline-based targets for reducing the backlog of Medicare appeals at the ALJ level. HHS also reported that additional appeals received at OMHA this quarter totaled 8,083, compared to 8,172 last quarter, with only 288 Recovery Audit Contractor-related receipts compared with 400 last quarter.