In addition to requiring HHS to implement AHA-backed interventions, the court should order HHS to maintain its own current efforts, the AHA filing argued.
Despite assurances that the government expects to clear its daunting backlog of Medicare appeals within about four years, the American Hospital Association has asked a federal judge to press forward with AHA-backed court-mandated interventions anyway.
The lobbying group accused Health and Human Services of dragging its feet in a dispute that hinders the ability of healthcare companies to do their work.
"Ending the backlog several years hence does not allow hospitals to upgrade equipment, repair aging facilities, or improve patient care now," AHA wrote in a federal court filing Friday.
Although the law requires HHS to resolve appeals at the administrative law judge (ALJ) level within three months, the average processing time has stretched to well over three years, according to data published by the HHS Office of Medicare Hearings and Appeals (OMHA). That means HHS has been in violation for years now, as the D.C. Circuit Court has confirmed, the AHA filing notes.
Citing a boost in appropriations and settlement activity, the government said this month that it expects to shovel its way out of this mess by the end of fiscal year 2022. In light of that progress, HHS argued, the court should refrain from requiring the AHA-backed solutions.
But that argument didn't fly in AHA's eyes. In addition to requiring HHS to implement the interventions proposed by AHA, D.C. District Court Judge James E. Boasberg should issue an order with a provision specifically requiring HHS to maintain its own current efforts to eliminate the backlog, AHA argued.
"Without it, HHS can alter its current programs at its whim, threatening to undo any current progress. And that possibility is not remote; even now, HHS signals that it might choose to alter its efforts based on unspecified 'other priorities,'" AHA wrote, quoting from HHS' earlier filing.
"If the Court is to ensure that its remedies stick until the backlog is eliminated, it should prevent HHS from unilaterally suspending its current backlog-reduction programs," AHA added.
AHA Responds HHS Medicare Appeals Backlog by HLMedit on Scribd
Steven Porter is an associate content manager and Strategy editor for HealthLeaders, a Simplify Compliance brand.
KEY TAKEAWAYS
The long-running dispute is hindering providers' ability to do their work, AHA contends.
The government argues that it is showing sufficient progress to be left to its own interventions.