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    Addressing the Medicare Appeals Backlog

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    Capstone Paper (243.3Kb)
    Date
    2017
    Author
    Davis, Kelly L.
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    Abstract
    When a Medicare provider is denied payment for a Medicare claim, the provider can appeal the decision to a five-level appeals system. However, the backlog of appeals at the third level of appeal is so large that statutory timeframes for decisions are not being met, and a federal judge has ordered the U.S. Department of Health and Human Services to clear the backlog by 2021. This capstone evaluates the issues causing and prolonging the backlog, offers a policy solution to address these issues, and analyzes the effectiveness, efficiency and administrative and political feasibility of the proposed solution.
    URI
    http://jhir.library.jhu.edu/handle/1774.2/40614
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