Exley v. Burwell: Fairness Hearing on Class Action Settlement about Delays in ALJ Appeals

Exley v. Burwell, 3:14-cv-1230 (JAM) (D. Conn.), in March of this year. Since then the government requested and the plaintiffs agreed to a revision in the proposed settlement. Because of this revision, the parties are posting notice to the class again and the Fairness Hearing (originally scheduled for May 31) has been rescheduled to August 1, 2016.

The settlement agreement remains mostly the same and the Office of Medicare Hearings and Appeals (OMHA) will still be taking the same measures to ensure prompt decisions in the ALJ appeals of Medicare beneficiaries. Most importantly, beneficiaries’ appeals will continue to receive priority for resolution, in essence moving to the front of the line ahead of other appellants.  The revision only affects appeals in which beneficiaries do not have any potential financial liability for the claims under appeal, and share a representative (such as a lawyer) with another party to the appeal (such as a provider). Those specific beneficiary appeals will not be prioritized unless the shared representative submits certain documentation to OMHA.  The purpose of the revision is to allow for more efficient administration of the settlement while still allowing beneficiary appeals in need of prompt resolution to receive priority.

The revised proposed settlement and notice to the class with information on filing objections and the rescheduled Fairness Hearing are below. The revision can be found in Section VIII.2 of the amended agreement.