BC Advantage - 2019 Issue 1

Courts Recognize Irreparable Injury Caused by Medicare Appeals Backlog

I.INTRODUCTION As providers and suppliers with pending requests for Office of Medicare Hearings and Appeals (OMHA) Administrative Law Judge (ALJ) hearings are acutely aware, there persists a significant backlog of appeals pending at the ALJ stage of appeal.Presently, there are 426,594 appeals pending and awaiting OMHA adjudication.   Despite a statutory mandate to "conduct and conclude a hearing… and render a decision on such hearing by not later than the end of the 90-day period beginning on the date a request for hearing has been timely filed,"  the average processing time for OMHA appeals...

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