On September 19, 2016, the U.S. District Court for the District of Columbia (D.D.C.) refused to stay a highly anticipated case seeking to force the government to comply with statutory deadlines governing the Medicare appeals process. Delays affecting the third stage in the appeals process—a hearing before an ALJ—have grown exponentially. Though a provider is entitled by statute to an ALJ hearing and determination within 90 days of the provider’s request, providers face years-long delays that increase every month. Providers win at the ALJ level more than 50% of the time, making the delays all the more unfair to the many providers that struggle daily with ever thinning operating margins as reimbursement generally decreases.

Originally published in Bloomberg BNA's Medicare Report - October 7, 2016.