The Center for Medicare Advocacy has filed a lawsuit on behalf of five Medicare beneficiaries who allegedly had to wait longer than the 90-day statutory limit to resolve appeals over Medicare claims denials
The proposed nationwide class-action lawsuit was filed in U.S. District Court in Connecticut against the Obama Administration. Under the Medicare Act, appeals are required to be heard by an Administrative Law Judge within 90 days after a request for a hearing. According to CMA, the current average wait time for a decision is 489 days.
This is not the first lawsuit to be filed concerning the appeals backlog. In May, a lawsuit was filed in an attempt to compel HHS to meet the statutory deadlines for ALJ review of Medicare claims denials. The lawsuit was filed by four organizations: the American Hospital Association; Mountain Home, Ark.-based Baxter Regional Medical Center; Knoxville, Tenn.-based Covenant Health; and Rutland (Vt.)Regional Medical Center.