Chief ALJ details 460k appeals backlog
Ryan Ball
Description
Collection
Title:
Chief ALJ details 460k appeals backlog
Creator:
Ryan Ball
Date:
1/20/2014
Text:
Wanted to pass this along to the listserv in hopes of practitioners sending the information to their member of congress.
A recently obtained memorandum from the Office of Medicare Hearings and Appeals (OMHA) Chief Administrative Law Judge Nancy Griswold to Medicare providers awaiting multiple Administrative Law Judge appeal hearings details the exponential growth in appeals to Medicare audits. The letter provides the most up-to-date appeals data that has been released by The Centers for Medicare and Medicaid Services (CMS) to date and includes some particularly damning statistics and statements about the appeals system.
Judge Griswold states that from 2010-2013, OMHA's claims workload grew by 184%. In just two years, the backlog of appealed claims has risen from 92,000 to 460,000, causing OMHA to suspend the assignment of hearing dates effective July 15, 2013.Citing a lack of additional resources allocated to handle the dramatic increase in appeals volume, Griswold states that in January 2012, their office averaged 1,250 appeals a week, in December 2013, they averaged 15,000. Average wait time now exceeds 16 months and with the current backlog, OMHA does not expect to begin assigning new ALJ hearing dates for atleast 24 months. As a point of reference, there are a total of 65 Administrative Law Judges nationwide.
More: <URL Redacted>
Ryan Ball
Director of Government Relations
Orthotic and Prosthetic Group of America
866-394-6868 ~ 319-610-2634
<Email Address Redacted> <mailto:<Email Address Redacted>>
<URL Redacted>
A recently obtained memorandum from the Office of Medicare Hearings and Appeals (OMHA) Chief Administrative Law Judge Nancy Griswold to Medicare providers awaiting multiple Administrative Law Judge appeal hearings details the exponential growth in appeals to Medicare audits. The letter provides the most up-to-date appeals data that has been released by The Centers for Medicare and Medicaid Services (CMS) to date and includes some particularly damning statistics and statements about the appeals system.
Judge Griswold states that from 2010-2013, OMHA's claims workload grew by 184%. In just two years, the backlog of appealed claims has risen from 92,000 to 460,000, causing OMHA to suspend the assignment of hearing dates effective July 15, 2013.Citing a lack of additional resources allocated to handle the dramatic increase in appeals volume, Griswold states that in January 2012, their office averaged 1,250 appeals a week, in December 2013, they averaged 15,000. Average wait time now exceeds 16 months and with the current backlog, OMHA does not expect to begin assigning new ALJ hearing dates for atleast 24 months. As a point of reference, there are a total of 65 Administrative Law Judges nationwide.
More: <URL Redacted>
Ryan Ball
Director of Government Relations
Orthotic and Prosthetic Group of America
866-394-6868 ~ 319-610-2634
<Email Address Redacted> <mailto:<Email Address Redacted>>
<URL Redacted>
Citation
Ryan Ball, “Chief ALJ details 460k appeals backlog,” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 1, 2024, https://library.drfop.org/items/show/235932.
