Dec 29, 2016

Why Medicare And Not Social Security?

     From 42 U.S.C. § 1395ff(d)(1)(A), having to do with Medicare appeals:
Except as provided in subparagraph (B), an administrative law judge shall conduct and conclude a hearing on a decision of a qualified independent contractor under subsection (c) of this section and render a decision on such hearing by not later than the end of the 90-day period beginning on the date a request for hearing has been timely filed.
     You might ask why there is a time limit on Medicare appeals and no time limit on Social Security appeals, most of which linger for well over a year. The answer is simple. The Medicare appeals are filed by medical providers. They have political clout. Social Security claimants don't. In fairness, the medical providers have had trouble enforcing the section of statute I've quoted above but they're just gotten a decision indicating that the courts may be willing to enforce the time limit language.


Anonymous said...

Comparing oranges to spatulas again.

Anonymous said...

Actually, you did not complete the facts. The caveat is that the 90 day rule may be waived by the claimant, and always is, since nobody wants to p*ss off the Judge...

Anonymous said...

this is cute.

If this

accurately reflects the number of ALJ Medicare decisions from 2016, then there's why they can issue a decision in 90 days.

By contrast, SSA has 1.1+ MILLION PENDING CLAIMS and FEWER THAN 1,500 ALJs. Lately, ODAR has issued about 800,000 dispositions a year.

But please, continue comparing SSA's process to Medicare's.