News: HHS ahead of schedule in court-ordered appeals backlog reduction

CDI Strategies - Volume 13, Issue 32

As of July 1, the Department of Health and Human Services (HHS) has reduced the Medicare appeals backlog at the Administrative Law Judge (ALJ) level by nearly 20%, according to a status report from HHS.

The reduction puts HHS ahead of schedule, according to AHA News, and comes as a response to a federal court ruling last year that established annual deadline-based targets for reducing the appeals backlog at the ALJ level. The lawsuit was brought by the American Hospital Association (AHA) and its member hospitals.

The ruling required that HHS achieve the following reductions from its own currently projected fiscal year (FY) 2018 backlog of 426,594 appeals:

  • 19% reduction by the end of FY 2019
  • 49% reduction by the end of FY 2020
  • 75% reduction by the end of FY 2021
  • 100% elimination by the end of FY 2022

According to the HHS report, there has been a net reduction of 82,935 appeals through the end of the second quarter of FY 2019, which equals a 19.4% reduction since the ruling last year.

Editor’s note: To read AHA News’ coverage of this story, click here. To read the full report from HHS, click here. To read more about last year’s court order, click here.

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News, Denials & Appeals