AHA - American Hospital Association

09/23/2022 | News release | Distributed by Public on 09/23/2022 12:52

AHA urges court to require HHS to resolve Medicare appeals backlog

AHA today urged the U.S. District Court for the District of Columbia to deny the Department of Health and Human Services' request to modify a court order requiring it to completely eliminate the remaining 19,802 Medicare appeals backlogged at the Administration Law Judge level. HHS now contends that it cannot fully comply with the order, stating that "it is unlikely that the backlog could be reduced completely to zero by the end of the fiscal year."

In a brief filed with the court, AHA said it would agree to a modest extension, but "the end goal must be the elimination of" the backlog. AHA also urged the court to require HHS to file monthly, rather than quarterly, status reports that include additional information on the remaining backlogged cases.

The court in 2018 ruled in favor of the AHA and its member hospital plaintiffs in the case, requiring the HHS to eliminate the appeals backlog by fiscal year 2022. Congress also allocated HHS enough funds for 170 ALJ-led teams to adjudicate the hundreds of thousands of Medicare appeals that had piled up at the agency.