Tag Archives: administrative law judge

AHA Offers HHS Solutions to Reduce Medicare Appeals Backlog

The American Hospital Association (AHA) recently advised the Department of Health and Human Services (HHS) to implement three solutions that would significantly reduce the Medicare appeals backlog at the administrative law judge level. Continue reading

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U.S. Senate Committee blames providers for appeals backlog

Forget the denials, reduce the appeals The U.S. Senate Finance Committee heard testimony and expressed dismay yesterday about the humongous backlog of appeals at the Office of Medicare Hearings and Appeals (OMHA), now totaling over 870,000 appeals, according to testimony … Continue reading

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“Finally Friday!” Strategies for Medicare Level 3 Appeals

FRIDAY October 17, 2014 Medicare Appeals at Level 3: Providers Left in the Lurch Veteran Appeals Attorneys Review Recent Experiences with ALJs How Can You Prepare & Respond? Watch the Replay and Get the Handouts Since CMS began re-educating the … Continue reading

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CMS Report Reveals 77% of Appealed RAC Denials Are Improper

Figures Show 55% of RAC Denials Are Improper If you read my previous article and then read the CMS Report to Congress for the RAC Program in FY2013, you can find figures that tell the story in the title of … Continue reading

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CMS FY 2013 Recovery Auditing Report to Congress Released

How CMS Continues to Mislead with Statistics CMS posted their report to Congress on recovery auditing in Medicare for FY2013, including many tables, charts and limited explanations, plus a bevy of perhaps accurate but misleading figures and percentages, obviously intended … Continue reading

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News from the Week of February 28

The Pause Expands Last Month, CMS extended the pause (I refuse to call it a moratorium) on RAC reviews of Medicare claims under the  2 Midnight Rule to a full year, from Oct. 1, 2013 to Sept. 30, 2014. MACs, … Continue reading

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News from the Week of February 14

OMHA Forum Shockers Quoting staggering numbers of appeals that are stuck in the mail room, much less not yet assigned to a Judge, the Administration Law Judges gave an organized forum. Chief ALJ Nancy Griswold stated that OMHA is committed … Continue reading

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“Finally Friday!” Interview: Former ALJ Nick Urevich

This session was recorded on Friday, May 24, 2013. Former CMS Administrative Law Judge Constantin “Nick” Urevich, now a practicing attorney in Los Angeles, speaks today about his experience hearing over 3,000 cases during his six year tenure working for … Continue reading

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