CHA News Article

Appeals Court Reverses Decision on ALJ Delays
Lawsuit on hospitals’ behalf revived

Earlier this week, a federal appeals court issued a ruling that will allow a re-hearing of a lawsuit that would compel the Department of Health and Human Services to adhere to the deadlines for reviewing Medicare claims denials. The lawsuit, brought by the American Hospital Association and several hospitals, was dismissed by a lower court and then appealed. The appeals court declared the backlog of delays for Medicare claims reviews is getting worse and sent the case back to the lower court. The appeals court also noted that the lower court should order HHS to comply with congressionally mandated deadlines if no progress is made toward solving the problem within a reasonable time frame.

CHA sees the court’s decision as confirming HHS has a clear duty to comply with the congressionally mandated deadlines, as well as hospitals’ right to demand compliance.