Part B Insider (Multispecialty) Coding Alert

Published on Mon Jun 30, 2014 PDF

Plus: Medical records sitting in the driveway? That’ll cost you $800,000.

If you’ve been waiting for the government to hear your ALJ appeal, you’re not alone—but you might be waiting a lot longer than you originally expected before you get an answer to your case.

Administrative Law Judge (ALJ) hearings are so behind that the government announced it wouldn’t process those appeals for the next two years, if not longer, angering practices that are at their fourth level of Medicare appeals and are waiting for answers.

Because of these delays, the American Hospital Association (AHA) filed a complaint in the U.S. District Court of Washington, DC to try and urge the Department of Health and Human Services (HHS) to rectify these backlogs.

“Lengthy, systemic delays in the Medicare appeals process, which far exceed statutory timeframes, are causing severe harm to providers of Medicare services,” the AHA says in the lawsuit, which was filed in May. “HHS’s unlawful delays are contrary to a clear statutory mandate requiring timely adjudication and must be eliminated.”

There’s no word on whether HHS will reopen its ALJ hearings process to speed these claims through the channel, but keep an eye on the Insider for more on whether HHS responds.

For a copy of the complaint, email editor Torrey Kim, CPC, at torreyk@codinginstitute.com.