ALJ

Congress, we must reform Medicare appeals

Congress, we must reform Medicare appeals

Ten years - that's how long the U.S. Department of Health and Human Services Office of Medicare Hearings and Appeals estimates the Medicare appeals backlog of 750,000 cases will take to clear.

High-profile consumer advocacy group sues over broken Medicare appeals process

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Long-term care providers have been outspoken in their criticism of the Medicare appeals process, which has all but ground to a halt. Now a class-action lawsuit says Medicare beneficiaries also are being harmed by the excessively long delays.

Congressional lawmakers grill top ALJ on appeals backlog, say too many providers are being put out of business

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Efforts to root out Medicare fraud have put far too many above-board providers in auditors' crosshairs, leading to a staggering backlog of appeals that has no easy fix, Congressional lawmakers and a top government official said during a hearing Thursday.

CMS announces Medicare appeals without administrative law judge hearings

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Long-term care providers will be able to appeal certain Medicare claims decisions without going through an administrative law judge hearing, the Office of Medicare Hearings and Appeals (OMHA) announced Thursday.