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AHA: Medicare Breaking the Law in Suspending RAC Appeals

Published
  • January 15 2014, 3:44pm EST

The American Hospital Association is reacting angrily to a decision of the Centers for Medicare and Medicaid Services to suspend appeals to administrative law judges of decisions from Medicare Recovery Audit Contractors for two years to clear up a massive 357,000 claims backlog, and says the move is illegal.

In a memo from the Office of Medicare Hearings and Appeals, the agency said it expected hearing wait times will continue to exceed six months after the two-year suspension. That’s a 30-month period during which hospitals won’t be paid for pended claims that reflect care provided to Medicare beneficiaries, the AHA says in a letter to members of Congress. “The need for fundamental RAC relief has become even more apparent and urgent,” the association noted.

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