BC Advantage - 2019 Issue 3

OMHA Medicare Appeals Backlog to be Eliminated by 2022

Granting Medicare appellants the relief they have been long awaiting, on November 1, 2018, the United States District Court for the District of Columbia issued a Memorandum Opinion and Order, mandating that the Secretary of the Department of Health and Human Services (HHS) resolve the significant backlog of appeals pending at the Office of Medicare Hearing and Appeals (OMHA) Administrative Law Judge (ALJ) stage of review by the end of FY 2022.   Appeals EnvironmentSection 1869 of the Social Security Act (42 U.S.C. § 1395ff) (the Act) sets forth the five-stage uniform Medicare appeals process applied...

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