OIG Finds No Problems with ALJ Transfer

Three years after Administrative Law Judge hearings
were transferred from the Social Security Administration to HHS
(as mandated under the Medicare Modernization Act), a follow-up report from the Office of Inspector General
said it found no problems. Shortly after the transfer, which took
place in July 2005, a report from the GAO criticized HHS for
limited access to in-person hearings and said the system was
suffering staffing shortages and had not yet fully implemented a
case-tracking system. At the time, HHS had only four in-person
hearing sites versus 141 under the SSA. In place of the in-person
hearings, however, HHS said it would use videoconferencing for most
appeals (see GAO Report
Raises New ALJ Transfer Concerns, HomeCare, September
2005).

The OIG report, issued Jan. 26, compared the first and third
years of operation for the Office of Medicare Hearings and Appeals —
which handles the third level of Medicare’s administrative appeals
process — and found during the time period OMHA’s caseload
increased 37 percent, from 20,676 to 28,361 cases. The report also
said OMHA had improved the timeliness of its decisions. For cases
with a 90-day decision requirement, OMHA decided 94 percent on time
in its third year compared to 85 percent in its first year of
operation. For cases without the 90-day requirement, the OIG said
OMHA decided 90 percent within six months compared with 88 percent
in its first year. OMHA also improved the quality of data in the
appeals system, OIG said.