On February 25, 2015, HHS Secretary Sylvia Burwell testified in a budget hearing before the House Committee on Appropriations, Subcommittee on Labor, Health and Human Services, Education, and Related Agencies, about the Obama administration’s $83.3 billion budget for HHS for FY 2016.  During the hearing, Secretary Burwell faced questions regarding, among other things, the large backlog of Medicare administrative appeals.  Secretary Burwell stated that HHS is aware of the backlog and mentioned three potential approaches to addressing the backlog. First, Secretary Burwell stated that, where appropriate, HHS plans to settle with providers to “get those numbers down.”  Second, Secretary Burwell noted that HHS has asked Congress for additional funding to support the Office of Medicare Hearings and Appeals (OMHA) to “work through the backlog,” including by funding additional specialized appeal judges to hear the appeals.  Third, Secretary Burwell mentioned proposed legislative changes, including establishing a fee for claims appeals to discourage appeals.  In that scenario, the provider would recoup the fee if the appeal is successful.

Secretary Burwell’s testimony and a webcast of the hearing is available here.

Reporter, Jennifer S. Lewin, Atlanta, + 1 404 572 3569, jlewin@kslaw.com.