DC Court Address Massive ALJ Backlog; Current Remedies Fall Grossly Short

Dani Kass reports in the subscription service LAW360 that the DC Circuit court has "jurisdiction to order HHS to cut down a massive backlog of disputed Medicare claims."  See the judicial decision online here.

According to Kass, the circuit court refers to an "exponentially increasing backlog" and that HHS receives "a year's worth of cases every two months or less."  The current case decision follows hearings in November 2015 (here).

I pointed out that this was obvious and inevitable two years ago on this blog, and that the then-contemporary government math statements wouldn't make sense, even to a seventh grader.

Quinn's April 2014 blog predicting this, here.

Prior Authorization - Medicare - And the President's FY2015 Budget

The 2015 Budget for HHS
The President's FY2015 budget for the Department of Health & Human Services - including the FDA and Medicare as well as the NIH - was released on March 4, 2014.  It's likely that only in Washington would a 146-page document be titled, "Budget in Brief."    The budget has risen from $886M in 2013 to a projected $958M in 2014 and $1.01M in 2015.  Most of this rise is due to the increasing populations in Medicare and Medicaid.

CMS and Prior Authorization - Current Policy Ideas

A particularly interesting item in the HHS policy roadmap - picked up in the trade journal GRAY SHEET (subscription) - is new authority for "Prior Authorization" for all Medicare services, at the discretion of the Secretary.   Prior authorization has most recently been required for electric wheelchairs in the durable medical equipment benefit; see the CMS webpage for this, and a CMS one-pager PDF.