D.C. Circuit Court Reverses Directives to HHS Regarding Appeals Backlog
Posted on Health Care Law News September 16, 2017 by Robert Nicholson
In a 2-1 Decision, the D.C. Circuit Court of Appeals reversed the district court’s order to HHS to clear the backlog of administrative appeals within four years. The appellate court found that the district court failed to adequately test HHS’s assertion that this mandate was impossible.
After considering the merits of a group of hospitals allegations regarding the backlog in administrative appeals, on December 5, 2016, the district court entered an order directing HHS to reduce the current backlog of cases pending at the ALJ level by 30% by the end of 2017; 60% by the end of 2018; 90% by the end of 2019; and 100% by the end of 2020. HHS appealed this decision to the D.C. Circuit Court of Appeals arguing that it would be impossible to comply with the required timetable without violating Medicare rules and regulations.
The D.C. Circuit Court of Appeals determined that the district court committed reversible error by ordering HHS to comply with the timetable proposed by the group of hospitals without first determining whether compliance was possible. Since HHS represented to the district court that complying with the timetable to decrease the backlog of appeals was not only impossible, but would actually result in an increase in the backlog of appeals, the D.C. Circuit Court of Appeals opined that the district court should have explored those claims before issuing an order.
The case was remanded to the district court which was ordered to determine whether HHS’s compliance with the timetable was in fact impossible.