A federal judge recently ordered the Department of Health and Human Services (HHS) to eliminate the backlog of Medicare claims appeals that are currently pending at the administrative level for the last four years.
“Plaintiffs sought relief from a morass in which hundreds of thousands of appeals were languishing in a highly backlogged administrative process,” according to the statement. “Now, after a motion for summary judgment, a motion to dismiss for lack of jurisdiction, an appeal to and remand from the D.C. Circuit and a motion to stay, the court can finally grant plaintiffs a remedy. The incantation of mandamus does not generate an instantaneous cure-all for complex problems, however, and so this opinion focuses on the form the relief will take.”
The AHA and three member hospitals were granted summary judgment in their case challenging the HHS.
“(It) is a victory for hospitals that continue to have billions of dollars in Medicare reimbursement tied up in a heavily backlogged appeals system,” AHA General Counsel Melinda Hatton said. “To meet the court-ordered backlog reductions, we trust that HHS will implement real reforms critical to resolving the backlog, including fundamental reforms of the Recovery Audit Contractor program.”
