HHS still says it can’t meet appeals deadline

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Thursday, March 9, 2017

WASHINGTON – The Department of Health and Human Services says it won’t meet a deadline to clear a backlog of appeals unless it settles the claims without seeing if they have merit.

In a status report, HHS told the D.C. Circuit court that its 687,382-claims backlog is projected to reach more than 1 million by the end of fiscal year 2021, according to Law360. The agency made a similar claim in February, saying it needed more money and cooperation from the provider community.

“Although the initiatives undertaken by HHS have significantly slowed the growth of the backlog, the significant annual reductions that this court has directed are not possible given current funding and legislative authorities,” HHS says.

The report also states that the Office of Medicare Hearings and Appeals would “violate its statutory obligations if it were to resolve cases without deciding them on the merits.”

HHS was ordered in December 2016 to find a way to reduce the backlog of cases at the Administrative Law Judge level by 30% at the end of 2017; 60% at the end of 2018; 90% at the end of 2019; and completely by the end of 2020.

Making things more challenging, HHS says: Hospitals and providers haven’t been as receptive to an initiative to settle claims as predicted.

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