CMS highlights actions to reduce RAC-related complaints, appeals

In a blog post today, Centers for Medicare & Medicaid Services Administrator Seema Verma highlights recent progress in reducing provider complaints related to the Medicare Recovery Audit Contractor program and associated backlog of appeals, including those generated by RACs, at the Administrative Law Judge level. Last November, a federal court ruled in favor of the AHA and reinstated a mandamus order establishing annual deadline-based targets for reducing the backlog of Medicare appeals at the ALJ level. The order by U.S. District Judge James Boasberg required the Department of Health and Human Services to achieve the following reductions from its own projected fiscal year 2018 backlog of 426,594 appeals: a 19 percent reduction by the end of FY 2019; a 49 percent reduction by the end of FY 2020; a 75 percent reduction by the end of FY 2021; and elimination of the backlog by the end of FY 2022. HHS did not appeal the judge's ruling in the case.