Court: No delay for appeals backlog suit targeting HHS

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A district court judge said the backlog and delays for Medicare appeals has only worsened.
A district court judge said the backlog and delays for Medicare appeals has only worsened.

The Department of Health and Human Services' request to put off litigation over its overwhelming Medicare appeals backlog was denied in late September. Thousands of long-term care provider appeals are believed to be tied up in the quagmire.

The HHS had asked to stay the case, which was brought against the agency by the American Hospital Association and three other hospital organizations, until Sept. 30, 2017. The delay would ideally allow the agency to move ahead on administrative and legislative efforts meant to tackle the backlog of more than 700,000 appeals, HHS officials said.

Those efforts include a June proposal from HHS that would increase the number of available Office of Medicare Hearings and Appeals adjudicators, and eliminate some parts of the appeals process entirely.

The U.S. District Court for the District of Columbia's ruling denied the HHS' motion to stay the litigation, shooting down the agency's proposed fixes as “impressive-sounding action items” that won't do much to curb the backlog as it grows to more than 1 million appeals in fiscal year 2020.

“The best medicine can sometimes be hard to swallow,” wrote Judge James E. Boasberg. “... the backlog and delays have only worsened … and the Secretary's proposed solutions are unlikely to turn the tide.”

In addition to denying the HHS request, the court turned down the hospital groups' recommendation that the court order the agency to resolve the appeals.

“The Court, however, does not possess a magic wand that, when waved, will eliminate the Backlog,” Boasberg wrote. “Plaintiffs' suggestion that the Court simply order HHS to resolve each of the pending appeals by the statutorily prescribed deadlines is extremely wishful thinking.”

AHA officials said they were pleased with the ruling.