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By Matthew Lawrence One option for dealing with the backlog of Medicare claims waiting for a hearing is to settle them. That’s up to the Centers for Medicare and Medicaid Services, not the Office of…
By Matthew Lawrence Next week (on October 29) Medicare’s Office of Medicare Hearings and Appeals (OMHA) is holding another appellant forum to discuss the ongoing backlog of Medicare claims waiting for a hearing. In one…
By Matthew Lawrence As we gear up for a second year of exchange marketplace enrollment, one issue to keep an eye on is the success we have at getting people who live in rural areas…
By Matthew Lawrence I have blogged a few times about the current backlog in Medicare’s coverage appeals process, including observations about a lawsuit by providers challenging the backlog in federal court in the District of…
By Matthew Lawrence Today the government moved for en banc rehearing in Halbig, as expected. (HT: Rachana Dixit Pradhan @ insidehealthpolicy.com.) I have not had the chance to review the petition but thought I would…
By Matthew Lawrence This morning the D.C. Circuit ruled that the ACA “unambiguously restricts the section 36B subsidy to insurance purchased on Exchanges “established by the State.” (See opinion here.) In other words, the court…
By Matthew Lawrence Several months ago, I promised to post my thoughts on the viability of the American Hospital Association’s threatened lawsuit against the Secretary of Health and Human Services challenging the growing backlog of…
By Matthew Lawrence and Elizabeth Guo Last month Medicare’s policy on coverage for sex change therapy changed somewhat. (See Matt’s earlier post here.) Specifically, Medicare’s Departmental Appeals Board invalidated the long-standing National Coverage Determination that…
By Matthew Lawrence Yesterday, Medicare’s Departmental Appeals Board set aside a thirty-year-old National Coverage Determination excluding Medicare coverage for sex change surgery. As a result, Medicare beneficiaries may now seek coverage for sex change surgery,…
By Matthew Lawrence At the same time that wait times at VA hospitals have been in the news here in the U.S., a recent report has put healthcare queues in the news in Canada. Specifically,…
