In a status report filed on March 6, 2017, HHS revised projections regarding the Medicare appeals backlog, which make it unable to meet a court-imposed deadline to eliminate the backlog by 2020. The status report was filed in connection with the American Hospital Association (AHA) v. Burwell litigation in the District Court for the District of Columbia.

As previously reported here, the AHA filed suit against HHS in 2014 seeking mandamus relief to compel HHS to meet its statutory deadline for administrative review of denial of claims for Medicare reimbursement. In December 2016, the District Court for the District of Columbia granted AHA’s motion for summary judgment and imposed deadlines for HHS to reduce the appeals backlog, including complete elimination of the backlog by December 31, 2020. HHS filed a motion for the court to reconsider its order, but in January 2017, the court denied HHS’s motion, finding that HHS had failed to meet the “stringent standard” to alter or amend the court’s judgment.

Most recently, in the March 2017 status report, HHS reported a current backlog of 667,326 appeals at the Office of Medicare Hearings and Appeals. HHS also projected the number of pending appeals to grow to 1,009,768 by September 30, 2021. HHS cited multiple reasons for the revised projections, including lack of provider interest in a reopened administrative settlement program, as well as current funding and legislative authorities under the new Administration.

The status report is available here.