AHA asks district court to reinstate deadline for HHS to clear Medicare appeals backlog

The American Hospital Association on Feb. 15 called on the U.S. District Court for the District of Columbia to reinstate the requirement that HHS clear its backlog of Medicare reimbursement appeals within five years.

In December 2016, a federal judge ordered HHS to incrementally clear the nearly 658,000 appeals pending before the agency's Office of Medicare Hearings and Appeals by Dec. 31, 2020. The order came after AHA and others filed a lawsuit against the then secretary of HHS.

HHS asked the judge to reconsider the order. The agency contended it would be impossible to incrementally reduce the backlog on the schedule in the court order without improperly paying claims. Judge Boasberg refused to rescind the order in January 2017. After an appeal from HHS, the U.S. Appeals Court for the District of Columbia overturned the order last August. That left it up to the lower court to decide whether, as HHS contended, it would be impossible to comply with the order's timetable for reducing the backlog.

In an order filed Feb. 15 with the U.S. District Court for the District of Columbia, the AHA and three member hospitals argued for reinstating the HHS deadline.

"Because the [HHS] secretary has not shown it is impossible to clear the backlog — minus, perhaps, some claims with serious program-integrity concerns — within five years, the court should require him to do so," the AHA and member hospitals wrote. "At the very least, the court should direct specific relief designed to get the backlog down as far as possible. But the court should not allow secretary to place his own convenience over plaintiffs' clear rights. Plaintiffs' cross-motion for summary judgment should be granted."

Ayla Ellison contributed to this report.

 

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