Court: HHS has 4 years to eliminate 700,000 Medicare appeals

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The court's order is aimed at remedying the that are "languishing in a highly backlogged administrative process"
The court's order is aimed at remedying the that are "languishing in a highly backlogged administrative process"

The U.S. Department of Health and Human Services has until Dec. 31, 2020 to eliminate the backlog of pending Medicare reimbursement appeals, a federal court ordered on Monday.

The order from the U.S. District Court for the District of Columbia follows a timeline proposed by the American Hospital Association, which brought the suit against HHS over its “highly backlogged administrative process.” Judge James E. Boasberg, who authored Monday's opinion, had stated in an earlier ruling that ordering the agency to resolve the backlog by the prescribed dates was “extremely wishful thinking,” but he changed course after briefs were filed by both parties.

HHS must first achieve a 30% reduction of the current backlog of more than 700,000 pending cases by Dec. 31, 2017, followed by 60% and 90% reductions by the end of 2018 and 2019, respectively. A total elimination of claims pending at the Administrative Law Judge level must be reached by the end of 2020.

In a previous court filing in the case between HHS and AHA, the federal agency stated that it believed a complete elimination of the backlog to be achievable by the end of 2019. While the case is now effectively terminated by the opinion, HHS may face further court action if it fails to meet the specified deadlines.  

“Satisfying the statutory demands for both accuracy and timeliness will no doubt prove challenging, but such is the task at hand,” Boasberg wrote.

HHS will also be required to provide progress reports on the backlog every 90 days, complete with updated figures and a rundown of any administrative or legislative actions that may impact its efforts.