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KNOW YOUR FACTS: ADMINISTRATIVE LAW JUDGE APPEALS

Published on Tue Jan 06, 2009

RAC appeals are running up ALJs' caseloads. A crucial decision from an administrative law judge could make or break your reimbursement.Learn these important ALJ appeals facts: • For cases not subject to the 90-day decision deadline, ALJs decided slightly more cases within six months -- 90 percent in 2008 versus 88 percent in 2005. But the decisions took slightly longer on average -- 119 days versus 110 days. • One-third of ALJs' increased caseload, which has jumped 37 percent since 2005, is due to appeals related to Recovery Audit Contractors (RACs). • ALJs are scheduling hearings more quickly than when they transitioned to the Department of Health and Human Services. It took 40 days from receiving a request for the ALJs to schedule a hearing in 2008, while it took 66 days in 2005. However, it took more time (six days) after scheduling to complete the hearing and issue a decision letter. [...]
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