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In a victory to health care providers waiting on lengthy appeals decisions, a federal judge ordered the Department of Health and Human Services (HHS) to eliminate its backlog of Medicare appeals claims in the next few years. The order comes after a damning report revealed a shockingly large backlog of Medicare claims appeals cases, with many stemming from home health.
Health care providers that receive fee-for-service claims denials can appeal those decisions. Over the past few years, the number of appeals filed by health care providers has exploded. In 2015, 123 million Medicare fee-for-service claims were denied, of which 3% were appealed.
As a result of ballooning appeals claims and growing frustration among health care providers waiting for appeals to be processed, the American Hospital Association and other affiliated entities filed suit.