Subscribe to RSS - ALJ backlog

ALJ backlog

Stakeholders fear QIC switch

‘It could exacerbate the situation at the ALJ, which is already untenable’

YARMOUTH, Maine – Stakeholders are not happy that C2C Innovative Solutions appears to be losing its gig as the Qualified Independent Contractor for HME.

Update: C2C phone demo


WASHINGTON – C2C Innovative Solutions, the QIC contractor, reopened 54,138 claims and withdrew 27,132 claims from the Administrative Law Judge backlog in 2017, according to a bulletin from AAHomecare.

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


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


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


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


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

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


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


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


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