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ALJ backlog

In brief: HHS details status of appeals backlog, supplier dropped from lawsuit

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12/01/2017

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.

DMEPOS appeals pile up

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10/19/2017

WASHINGTON – DMEPOS appeals at the Administrative Law Judge level make up about 49% of total appeals in FY 2017, consistent with the two previous years, according to a bulletin from AAHomecare.

In brief: Access survey slams bid program, CMS withdraws O&P rule

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10/13/2017

WASHINGTON – More than 60% of case managers report an increase in the number of Medicare beneficiaries who have developed medical complications, received emergency care or were readmitted to a hospital due to issues related to obtaining proper and/or timely access to DME,

ALJ wait time nears three years

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10/12/2017

WASHINGTON – The average wait time to get a hearing before an Administrative Law Judge is 1,082 days, a 41-day increase from earlier this year and a 205-day increase since last year, according to AAHomecare. The overturn rate at the ALJ is 28.3%.

Appeals backlog wears on

‘Hopefully we’re still in business when our cases get to a judge,’ says provider Donna Barraclough
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05/19/2017

YARMOUTH, Maine – A whopping 92% of respondents to a recent HME Newspoll say they have claims stuck at the administrative law judge level and are waiting—and waiting—for hearing dates.

In brief: CMS solicits input on reimbursement, nat’l RAC ready to roll

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03/10/2017

WASHINGTON – CMS has scheduled a call to solicit stakeholder input on its methodology for using information from the competitive bidding program for adjusting Medicare fee schedule amounts in non-bid areas.

HHS still says it can’t meet appeals deadline

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03/09/2017

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.

Bob Soltis: Former ALJ tells all

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09/23/2016

CLEVELAND – Spoken like a true lawyer, Bob Soltis’ advice for HME providers working claims through the Medicare appeals process: be brief and be concise.

Q&A: Bob Soltis

Former ALJ tells all
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07/29/2016

CLEVELAND – Spoken like a true lawyer, Bob Soltis’ advice for HME providers working claims through the Medicare appeals process: be brief and be concise.

ALJ wait time increases

OMHA, C2C pick away at backlog, but still no ‘broad relief’
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05/27/2016

WASHINGTON – The wait time for an Administrative Law Judge hearing keeps growing—a symptom of ongoing problems with the audit process, say industry attorneys.

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