HHS finalizes changes to Medicare appeals procedures

The Department of Health and Human Services today released a final rule that attempts to address the significant backlog in Medicare appeals by making certain procedural changes. Specifically, the final rule in some cases allows attorney adjudicators to hear appeals in lieu of Administrative Law Judges and allows the HHS Departmental Appeals Board to designate certain decisions as precedential. “HHS’s minor changes to the appeals process fall short of the major reforms necessary to clear the backlog as required by recent court order,” said AHA Executive Vice President Tom Nickels. “We will work with HHS to identify significant changes to the Medicare audits and appeals processes that will alleviate the burden on hospitals and – most importantly – prevent this from happening again.”