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Tag: Administrative Law Judge


Appeals backlog wears on

May 19, 2017Liz Beaulieu, Editor

YARMOUTH, Maine - A whopping 92% of respondents to a recent HME Newspoll say they have claims stuck at the administrative law judge level and are waiting—and waiting—for hearing dates.The largest majority of poll respondents (28%) say their claims are going on three years old.“This is a major cash flow problem,” wrote Mary Klavoon of Buffalo Wheelchair in Buffalo, N.Y. “We buy and pay for equipment, and dispense to our qualified Medicare recipients, only to have to wait...

Administrative Law Judge, ALJ backlog, appeals, audits

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ALJ wait time increases

May 27, 2016Theresa Flaherty, Managing Editor

WASHINGTON - The wait time for an Administrative Law Judge hearing keeps growing—a symptom of ongoing problems with the audit process, say industry attorneys.“I don't think the problem lies in appeals,” said Ross Burris, an attorney in the Atlanta office of Polsinelli. “The problem lies lower down, either with audits that are too broad, or MACs that are just rubberstamping what the audit contractors are doing.”In the first quarter of 2016, the wait was 796 days. By the...

Administrative Law Judge, ALJ backlog, OMHA, QIC demo

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Poll: 41% have been waiting at least one year for hearing

November 15, 2013Leah Hoenen

YARMOUTH, Maine - Long delays have made appealing denied claims a painful process for HME providers, forcing them to wait sometimes years for payment.Nearly all of the 120 respondents to the December HME NewsPoll (91%) say they have one or more appeals awaiting a hearing with an administrative law judge (ALJ), the third level of appeal. Forty-one percent of respondents say they've already been waiting at least a year.“Many of these claims are showing up as open invoices on our books and presenting...

Administrative Law Judge, appeals, CMS, HME NewsPoll, office of medicare hearings and appeals, OIG

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