Exhaustion Doctrine Administrative Appeals

News & Analysis as of

A Favorable, New Climate for Challenging Medicare Appeals

Over the past decade, health care providers seeking to challenge Medicare claim denials have faced increasing delays in reaching what many consider the most important step in the Medicare appeals process - a hearing before an...more

2nd Cir. Joins 7th & D.C. Requiring Exhaustion to Challenge SEC ALJs

The Second Circuit has affirmed dismissal of “diva of distressed” Lynn Tilton’s constitutional challenge to the SEC’s administrative forum, holding that issue isn’t reviewable by the courts until an appeal after two levels of...more

Court Rules Hospitals Must Exhaust HHS Administrative Appeals Process for Medicare Advantage Out-of-Network Payment Dispute

According to a Georgia federal district court ruling issued on February 11, 2016, a group of hospitals must exhaust their out-of-network Medicare Advantage (MA) payment dispute through the Department of Health and Human...more

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