AHA asks court to order HHS to implement three appeals backlog solutions

The AHA Friday asked a federal judge to require the Department of Health and Human Services to implement three “practicable solutions” to reduce the backlog of Medicare claims appeals at the administrative law judge level: offer reasonable settlements to hospitals and other Medicare providers; delay repayment of some disputed Medicare claims and toll the accrual of interest on those claims; and impose penalties on recovery audit contractors for poor performance. “The Secretary has the authority to implement each reform, which together will target the existing backlog of appeals and reduce the number of future appeals,” AHA said in a brief filed in American Hospital Association v Burwell. The case, brought by AHA and three member hospitals, challenges HHS for failing to meet statutory deadlines for processing Medicare claims appeals. At an Oct. 3 status hearing, the judge indicated he was prepared to compel the government to meet the statutory deadlines for processing Medicare claims appeals, but first ordered additional briefing on what remedial steps HHS should take to meaningfully reduce the claims backlog.