Administrative Law Judge

Extra audits clog and freeze  Medicare appeals process

Extra audits clog and freeze Medicare appeals process

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Providers who want to have an administrative law judge consider a Medicare claim appeal can save their breath and memos for now.

'Patience is wearing thin' on Medicare appeals backlog, long-term care leader says

'Patience is wearing thin' on Medicare appeals backlog, long-term care leader says

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Long-term care advocates anxious about the stalled Medicare claim appeals process were not soothed after a forum with government officials Wednesday. Last month, providers learned that new appeals to administrative law judges would not be heard for at least two years.

'Irreparable harm' to the nursing home is not enough to stay a Medicare and Medicaid termination during an appeal, judge rules

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A nursing home appealing a Medicare and Medicaid termination must meet numerous criteria to qualify for a stay of the termination, even if the facility will likely close before the appeal is decided, a federal judge has ruled.

Medicare appeals at the administrative law judge level will be suspended for two years due to backlog, agency announces

Medicare appeals at the administrative law judge level will be suspended for two years due to backlog, agency announces

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Long-term care providers filing to have a Medicare claims appeal heard by an administrative law judge will not have the case assigned to a judge for at least two years, according to the Office of Medicare Hearings and Appeals.

Resident's gruesome death warrants steep fines: court

Resident's gruesome death warrants steep fines: court

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The Centers for Medicare & Medicaid Services was justified in fining a Kentucky skilled nursing facility $4,050 a day for three months following a resident's death, a U.S. Appeals Court recently ruled.

Things heating up in case of the runny eggs

Things heating up in case of the runny eggs

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Looks like CMS and nursing home inspectors have more than a little egg on their face, thanks to a recent circuit court ruling in favor of a wrongly accused operator.

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