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HHS reports 25% reduction in appeals backlog

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10/16/2019

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

New court decision on recoupments

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02/15/2019

WASHINGTON – Healthcare attorney Elizabeth Hogue has been watching closely as numerous courts go back and forth on whether or not CMS should be stopped from recouping overpayments until after the ALJ level, but she thinks a recent court’s decision is “really serious.”

CMS expands phone demo

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10/23/2018

JACKSONVILLE, Fla. – CMS will expand a demonstration project that allows HME providers to speak with reconsideration professionals by phone to try and resolve their cases to jurisdictions A and B on Nov. 1.

Lack of unified stance on settlements, poll finds

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10/12/2018

YARMOUTH, Maine – It turns out, even with the huge backlog of Medicare appeals stuck at the administrative law judge level, whether or not to accept a settlement is as divisive an issue as it gets in the HME industry.

Another court issues TRO on CMS

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07/24/2018

BROWNSVILLE, Texas – A court has again issued a temporary restraining order prohibiting CMS from recouping overpayments until after the administrative law judge level, this time on behalf of Adams EMS, according to healthcare attorney Elizabeth Hogue. In June, the U.S.

Court agrees broken appeals systems is unfair

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06/22/2018

DALLAS – A U.S. District Court’s recent opinion prohibiting CMS from recouping alleged overpayments from a provider going through the appeals process until after the administrative law judge level sends a strong message, industry stakeholders say.

Judge getting impatient with HHS over massive ALJ backlog

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Friday, April 6, 2018
Elizabeth Hogue

I recently wrote an article entitled "Court Says No Recoupment Until After ALJ Hearings."  This article was about a court decision in which the judge said that recoupment of an extrapolated overpayment as a result of a ZPIC audit could not begin until after ALJ hearings were held.

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HHS details status of appeals backlog

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11/29/2017

FALLS CHURCH, Va. – The Office of Medicare Hearings and Appeals receives more than a year’s worth of appeals work every 24 weeks at the third level of appeals, according to a recent PDF posted to the agency’s website.

Session spotlight: Be prepared for your day in court

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10/24/2017

ATLANTA – Many HME providers end up in front of an administrative law judge to contest a reimbursement denial, but too often they don’t know what they’re up against, says speaker Ross Burris.

CMS contractor expands phone demo

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11/04/2016

JACKSONVILLE, Fla. – C2C Innovative Solutions, the contractor handling the second level of the Medicare appeals process, has received the green light from CMS to expand a demonstration project that allows HME providers to speak with reconsideration professionals by phone to try and resolve their cases.

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