News: HHS cut backlog of Medicare appeals by nearly half

According to a status report, the United States Department of Health and Human Services (HHS) has reduced its backlog of Medicare appeals at the Administrative Law Judge level by 43% through the middle of June.

As of the end of the second quarter of 2020, only 242,995 of the initial 426,594 appeals remain pending at the Office of Medicare Hearings and Appeals. The rate at which the HHS has reduced backlog appeals in 2020 is ahead of its initial reduction plan.

The reduction is in response to a 2018 court ruling in favor of the American Hospital Association (AHA) and its member hospital plaintiffs. The ruling established annual deadline-based targets aiming to reduce the number of backlog Medicare appeals at the Administrative Judge level. The ruling required the HHS fully eliminate the backlog by the end of fiscal year 2022, which it is currently on track to do at the current rate.

Editor’s note: The HHS status report can be found here. Initial ACDIS coverage of the reduction plan can be found here. For more information about CDI professionals’ role in the appeals process, click here.