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Post by pppark on Feb 9, 2024 0:17:33 GMT -5
Does anyone have any intel as to whether OMHA will RIF their ALJs or close field offices in the near future?
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Post by Judge McJudgeypants on Feb 9, 2024 0:46:55 GMT -5
I was wondering when this was going to get brought up here...
The official answer is ... not at this time.
That does not mean the possibility is not scaring some folks.
I think the outcome of the most recent VERA/VSIP offer, the new proposed budget that's supposed to come out in March, and receipts during late Spring/early summer will ultimately tell the tale.
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Post by prescient on Feb 9, 2024 12:24:03 GMT -5
What would be the reason? Not enough case load?
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ike82
Full Member
Posts: 45 
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Post by ike82 on Feb 9, 2024 15:43:20 GMT -5
In 2014, HHS, regarding OMHA decision timeliness, was sued by the American Hospital Association (2014-cv-00851). At that time, OMHA developed a backlog in cases due to several provider/suppliers requesting an OMHA hearing regarding every denial of Medicare.
On November 1, 2018, the court issued a mandamus order regarding a timeline for reducing the OMHA backlog of undecided cases; at the time of the mandamus order, the backlog pending before ALJs in OMHA was over 400,000 cases.
In 2018 and 2019, OMHA hired a substantial number of ALJs to meet the requirements of the court order to eliminate the backlog of cases. By the end of 2019, there were approximately 160 OMHA ALJs.
In early 2023, the OMHA backlog was less than 1,000 cases. In April 2023, the court terminated the mandamus order and withdrew the court’s supervision.
OMHA has 10 field offices- Albuquerque, Arlington, Atlanta, Cleveland, Irvine, Kansas City, Miami, New Orleans, Phoenix, and Seattle. Denver is a satellite office to the Seattle field office. For all levels of ALJs, OMHA has approximately 130 ALJs, which is down from approximately 170 ALJs in 2019.
A RIF has been mentioned within OMHA for years, yet no RIF has taken place. It is possible that a RIF may never happen; also, it is possible that the DAB (which has Administrative Appeal Judges and ALJs) may acquire OMHA ALJs reducing any alleged need for a RIF in OMHA. If there is a RIF, there may be a substantial reduction of SSA ALJ positions available to the public as OMHA RIF ALJs would have priority for SSA ALJ positions.
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Post by Burt Macklin on Feb 9, 2024 15:48:21 GMT -5
In 2014, HSS, regarding OMHA decision timeliness, was sued by the American Hospital Association (2014-cv-00851). At that time, OMHA developed a backlog in cases due to several provider/suppliers requesting an OMHA hearing regarding every denial of Medicare. On November 1, 2018, the court issued a mandamus order regarding a timeline for reducing the OMHA backlog of undecided cases; at the time of the mandamus order, the backlog pending before ALJs in OMHA was over 400,000 cases. In 2018 and 2019, OMHA hired a substantial number of ALJs to meet the requirements of the court order to eliminate the backlog of cases. By the end of 2019, there were approximately 160 OMHA ALJs. In early 2023, the OMHA backlog was less than 1,000 cases. In April 2023, the court terminated the mandamus order and withdrew the court’s supervision. OMHA has 10 field offices- Albuquerque, Arlington, Atlanta, Cleveland, Irvine, Kansas City, Miami, New Orleans, Phoenix, and Seattle. Denver is a satellite office to the Seattle field office. For all levels of ALJs, OMHA has approximately 130 ALJs, which is down from approximately 170 ALJs in 2019. A RIF has been mentioned within OMHA for years, yet no RIF has taken place. It is possible that a RIF may never happen; also, it is possible that the DAB (which has Administrative Appeal Judges and ALJs) may acquire OMHA ALJs reducing any alleged need for a RIF in OMHA. If there is a RIF, there may be a substantial reduction of SSA ALJ positions available to the public as OMHA RIF ALJs would have priority for SSA ALJ positions. I think the biggest question is if they either attempt geographic RIFs to just shutter entire regional offices, or attempt it OMHA wide to reduce a % of the ALJ Corps. Morale is the at the absolute lowest I’ve seen it. |
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Post by dshawn on Feb 9, 2024 20:52:11 GMT -5
Hmmmn? In another thread it appears SSA is hoping to do some later in the evening hearings. Well, when it is 6 PM EST it is only 4 MST and 3 PST. I imagine if one can do M’care stuff one can learn the 5-step. Open up the interagency transfer list and see if anyone in the MST or PST time zones can help a sister agency out. If I remember correctly, used to be under one umbrella not all that long ago. Just a thought.
Full disclosure: I am one who is under the threat of a RIF. I don’t disagree with the morale comment. Was a great gig. Much less so as of late.
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Post by Thomas fka Lance on Feb 9, 2024 21:06:14 GMT -5
Hmmmn? In another thread it appears SSA is hoping to do some later in the evening hearings. Well, when it is 6 PM EST it is only 4 MST and 3 PST. I imagine if one can do M’care stuff one can learn the 5-step. Open up the interagency transfer list and see if anyone in the MST or PST time zones can help a sister agency out. If I remember correctly, used to be under one umbrella not all that long ago. Just a thought. Full disclosure: I am one who is under the threat of a RIF. I don’t disagree with the morale comment. Was a great gig. Much less so as of late. Since quite a few started at SSA prior to going to Medicare they already know the 5 step process which will make the transition even easier, should it need to happen |
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Post by dshawn on Feb 9, 2024 22:45:47 GMT -5
I A transfer may be the wrong terminology. I guess “detailing” some out for a time. Well aware many have SSA experience. Heck, I might as well. I would rather work at 10pm than be RIF’d. I always thought RIF was a good thing. Reading is Fundamental. Shows you what I know.
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Post by johnthornton on Feb 10, 2024 18:00:07 GMT -5
"Since quite a few started at SSA prior to going to Medicare they already know the 5 step process which will make the transition even easier, should it need to happen "
There may be some who started at SSA prior to going to Medicare but not a large number--The split was twenty years ago.
I started just after the split and I can retire at any time.
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Post by dshawn on Feb 10, 2024 18:11:06 GMT -5
"Since quite a few started at SSA prior to going to Medicare they already know the 5 step process which will make the transition even easier, should it need to happen " There may be some who started at SSA prior to going to Medicare but not a large number--The split was twenty years ago. I started just after the split and I can retire at any time. Some also came over when OMHA expanded its footprint a little over four years ago. |
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Post by natethegreat on Feb 11, 2024 12:08:37 GMT -5
"Since quite a few started at SSA prior to going to Medicare they already know the 5 step process which will make the transition even easier, should it need to happen " There may be some who started at SSA prior to going to Medicare but not a large number--The split was twenty years ago. I started just after the split and I can retire at any time. Some also came over when OMHA expanded its footprint a little over four years ago. Exactly. I know of at least one OMHA ALJ who, after a few years at SSA, changed agencies due to the preferring the OMHA hearing model. |
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Post by johnthornton on Feb 11, 2024 16:46:00 GMT -5
Some also came over when OMHA expanded its footprint a little over four years ago. Exactly. I know of at least one OMHA ALJ who, after a few years at SSA, changed agencies due to the preferring the OMHA hearing model. I guess a lot of people didn't consider the possibility of a RIF in the future. |
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Post by Burt Macklin on Feb 11, 2024 21:05:00 GMT -5
Exactly. I know of at least one OMHA ALJ who, after a few years at SSA, changed agencies due to the preferring the OMHA hearing model. I guess a lot of people didn't consider the possibility of a RIF in the future. No. Sh*t. |
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Post by Judge McJudgeypants on Feb 11, 2024 21:51:36 GMT -5
I remember at the training in Kansas City, the then-Chief Judge gave opening remarks assuring us of the job security that came along with the position, saying something akin to “this could be our last job if that’s what we wanted because it would be nearly impossible to take this job away from us once we had achieved it.” It was such a comforting thought. Ah, those were the good old days.
At this point, at least for me, it’s all very Que Sera, Sera. Not much I can do about it without better intel, which will take time. I hope we all get to stay on as OMHA ALJs if that’s what we want, affirming Judge Grisewold’s sentiment. But if not, I hope anyone who gets RIF’d finds an even better, even happier gig.
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Post by atlattadv on Feb 12, 2024 8:54:09 GMT -5
Exactly. I know of at least one OMHA ALJ who, after a few years at SSA, changed agencies due to the preferring the OMHA hearing model. I guess a lot of people didn't consider the possibility of a RIF in the future. The pandemic (waivers of certain requirements and less claim reviews), changes in Medicare processing (more preauthorizations), a change in appeal practices by providers and suppliers (no longer appealing every denial), and a lot of hard work got us here. At least two of the four causes could not have been predicted. I just hope TPTB remember all the hard work we put in before they decide to implement a RIF. Also, I still feel like I have plenty of work. The types of cases we are getting now are more document-heavy and tend to have more complex issues. My docket no longer consists of a large number of appeals that will be withdrawn prior to the hearings or otherwise dismissed for filing defects and the like. CMS contractors also seem to be doing more statistical sample/extrapolation cases involving more complicated/document intensive services than they once did, such as reviewing hospice and home health cases. One of these “big box” cases can easily take up weeks of time if reviewed thoroughly. Finally, our staff resources are down. We had a plethora of attorneys at one point who assisted with reviewing cases ahead of hearings, drafting decisions, preparing orders, doing research, etc. Those resources are largely no longer available to us. While the raw number of appeals is down, I don’t think that is an accurate reflection of our workloads. Comparing our dockets now to what they were a couple years ago is like comparing apples and oranges. Our current workloads allow for more thorough reviews of these more complex/document heavy cases, and if we have a steep decline in the number of ALJs, I predict a quick return of the back log. I don’t think a RIF of OMHA ALJs is going to happen, but I do not have any inside knowledge to support my prediction. I know others are far more concerned about it, so maybe I’m just naive. |
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ike82
Full Member
Posts: 45
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Post by ike82 on Feb 12, 2024 13:22:18 GMT -5
At the swearing in at Kansas City there were many SSA ALJs who had come over to OMHA. I do not recall what Chief Judge Griswold stated about job security, but, in any event, it seemed as if OMHA would be a secure job.
While I was told each team at OMHA was to have two Legal Assistants and two Attorney Advisors, it did not happen for all the new ALJs. Then OMHA stopped hiring new Attorney Advisors and attrition led to very understaffed teams.
When we were still in the office prior to March 2020, I mentioned to the HOD that I had worked on reducing a hearing backlog at my prior employer. I noted for the HOD that based upon my experience the current situation would stay as bad or get worse once the backlog was eliminated as easier appeals (SOL, amount in controversy, withdrawals, defaults etc.) would be completed and we would expect much fewer of those outcomes. Also, the 90-day deadline would put more pressure on the ALJs beyond the pressure of meeting that deadline for the beneficiaries. As stated by another ALJ at a meeting about a year later, all the easy appeals were gone or nearly gone.
Here are a few thoughts on a RIF. The talk of a RIF is self-fulfilling for fear; one source may lead to many people hearing about the alleged RIF, yet nothing may be happening. A RIF takes a substantial time to implement; unless a plan for a RIF started formulating with TPTB last year, then there should not be a RIF soon. Only TPTB have control over a RIF, and no amount of worrying by those who may be impacted by a RIF will lead to an outcome that is different than that already determined by TPTB.
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Post by atlattadv on Feb 12, 2024 14:24:45 GMT -5
Only TPTB have control over a RIF, and no amount of worrying by those who may be impacted by a RIF will lead to an outcome that is different than that already determined by TPTB. To your final point, if TPTB allow such rumors and fears of a RIF to percolate among ALJs, the desired outcome may be achieved via retirements, transfers, and voluntary separations, thus avoiding the need for a RIF. I suppose time will tell. |
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Post by dshawn on Feb 12, 2024 18:57:32 GMT -5
With the backlog in the rearview mirror and the current downward trend in new cases at OMHA, yet an expectation they could increase when the RACs, ZPICS, SMRCs, etc. get their feet under themselves again, and with an eye toward not recreating the backlog (which must have been at least partially pushed up to the AC) has the agency given any thought to “Senior Status”?
The Art. III federal courts have done this for years. Judges with a certain number of years of experience take “Senior Status” and work a much smaller caseload (it used to be 20%) rather than outright retiring or resigning. Obviously, they would get reduced pay commensurate with the hours, but foot still in the door and stuff to do beyond golf and quilting. The upside—they remain potentially available should a crush of cases come to fruition. FTEs reduced in the short term. Additional benefit, no need to stop everything to train a new cadre and you don’t have the brain drain of losing good, experienced, productive ALJs.
It is just a thought. I have them occasionally. They are not all good. My SO never hesitates to remind me of this. I am confident Pixie will also so advise if I am all wet here.
Thoughts? Too hard to administer? Not worth it. Someone like me wouldn’t qualify, but it might help in the short run.
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Post by neufenland on Feb 13, 2024 7:10:55 GMT -5
With the backlog in the rearview mirror and the current downward trend in new cases at OMHA, yet an expectation they could increase when the RACs, ZPICS, SMRCs, etc. get their feet under themselves again, and with an eye toward not recreating the backlog (which must have been at least partially pushed up to the AC) has the agency given any thought to “Senior Status”? The Art. III federal courts have done this for years. Judges with a certain number of years of experience take “Senior Status” and work a much smaller caseload (it used to be 20%) rather than outright retiring or resigning. Obviously, they would get reduced pay commensurate with the hours, but foot still in the door and stuff to do beyond golf and quilting. The upside—they remain potentially available should a crush of cases come to fruition. FTEs reduced in the short term. Additional benefit, no need to stop everything to train a new cadre and you don’t have the brain drain of losing good, experienced, productive ALJs. It is just a thought. I have them occasionally. They are not all good. My SO never hesitates to remind me of this. I am confident Pixie will also so advise if I am all wet here. Thoughts? Too hard to administer? Not worth it. Someone like me wouldn’t qualify, but it might help in the short run. You can call it “senior status” to feel like an Art. III judge (they still get their full pay), but I’m pretty sure OPM will call it “part time employee.” Well, to give Lucia its due, “part time inferior officer.” |
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Post by johnthornton on Feb 13, 2024 7:28:43 GMT -5
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