Monthly Archives: August 2014

Class Action Suit Filed Against HHS Over Medicare Appeal Hearings

On August 26th, Lawyers for the Center for Medicare Advocacy filed a class action suit in the U.S. District Court in Connecticut ( Lessler et al. v. Burwell , 3:14-CV-1230).  The suit, filed on the behalf of five named Medicare beneficiaries from Connecticut, New York and Ohio contends that each of the plaintiffs waited more than three months for a hearing and decision by an Administrative Law Judge (ALJ) on their Medicare appeals, in direct violation of the statutory requirement that says an appeal decision must be issued within 90 days. Continue reading

GAO Report: CMS Action Needed to Improve Effectiveness and Efficiency of Postpayment Claims Reviews

A recent GAO report on Medicare Program Integrity concludes that, while CMS has taken a number of steps to guide, oversee, and coordinate its contractors’ postpayment claims review efforts, further actions by CMS could help improve the efficiency and effectiveness of its contractors’ efforts. Specifically, the GAO report recommends that the Administrator of CMS take the following four actions:

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