In a brief filed today in federal court, the AHA and three member hospitals reaffirmed their support for four broad categories of non-deadline remedies to reduce the backlog of Medicare billing appeals awaiting adjudication at the Administrative Law Judge level. They also proposed that the court reconsider a deadline-based remedy, since the Department of Health and Human Services recently reported that it has the budget to adjudicate more appeals, and expects a 2022 end date for the backlog. In light of that projection, HHS urged the court to require only periodic status reports. “Ordering a deadline-based remedy in addition to requiring periodic status reports … will have two important effects,” today’s brief from AHA and the hospitals points out. “First, making a deadline binding and not just aspirational will keep HHS from backsliding. … Second, entering a deadline with fixed reduction targets each year along the way gives HHS an aggressive goal and ensures steady interim progress.”

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The Centers for Medicare & Medicaid Services May 28 issued a final rule making changes to the Increasing Organ Transplant Access Model beginning July 1.…
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Perspective
Public
Approximately 35 million Americans are enrolled in Medicare Advantage plans in 2026, and that number is expected to grow to about 45 million MA enrollees by…