HHS reports 25% reduction in appeals backlog

Wednesday, October 16, 2019

WASHINGTON – The Department of Health and Human Services has reduced the backlog of Medicare appeals at the administrative law judge level by 25% through June 30, according to a status report provided to a federal court and obtained by the American Hospital Association.

The status report is part of a federal court ruling last year that established annual deadline-based targets for reducing the backlog of Medicare appeals at the ALJ level.

From Nov. 1, 2018, through the end of the third quarter of fiscal year 2019, there has been a net reduction of 108,340 appeals pending at the Office of Medicare Hearings and Appeals, leaving a total of 318,254 appeals pending, a 25.4% reduction from the 426,494 appeals pending on Nov. 1, 2018, HHS reports.

Last year’s ruling in favor of the AHA required HHS to achieve the following reductions: a 19% reduction by the end of FY2019; 49% by the end of FY 2020; 75% by the end of FY 2021; and no backlog by the end of FY 2022.