Processing Time For Medicare Appeals Expected To Go Up

Judge Nancy J. Griswold, Chief Administrative Law Judge (ALJ) and Director of the Office of Medicare Hearings and Appeals (OMHA), recently met with the National Hospice and Palliative Care Organization (NHPCO) staff. The workload for the ALJ was discussed in depth, as well as the backlog and any considerations for a faster response to appeals. Judge Griswold reported that the average processing time for fiscal year 2015 is 547.1 days and is expected to go up.

There is a new resource for appellants who want to check on the status of an email. Go to the OMHA website and click on “Appeal Status Lookup.” Judge Griswold also commented that the settlement from CMS for hospitals could remove up to 280,000 appeals from the ALJ backlog, but is not expected to completely fix the issue. Providers can also register for the OMHA listserve to get information on the ALJ appeals.



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