CHA News Article

AHA Conference Call Highlights Pending Litigation for Timely Administrative Review of RAC Denials

In December 2013, the Department of Health and Human Services (HHS) announced a moratorium on assigning new provider appeals resulting from Recovery Audit Contractor (RAC) reviews to an Administrative Law Judge (ALJ) for at least 24 months. For hospitals, the moratorium means that new appeals to the ALJ can realistically take close to three years or longer before they are even heard, not including time for a decision to be issued. The American Hospital Association (AHA) recently filed a lawsuit in federal court to compel HHS to comply with statutory deadlines for deciding hospitals’ appeals of RAC claim denials.

On June 10 at 11 a.m. (PT), AHA will host a 60-minute conference call to discuss the lawsuit and what individual hospitals can do to support this legal effort. In addition, the call will include discussion of escalating certain appeals — such as those that have not been heard and decided by an ALJ within 90 calendar days of the date of a request for hearing — from the ALJ to the Departmental Appeals Board level and how that might support the pending lawsuit. The dial-in number for the call will be sent to hospitals once they have completed online registration.

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