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Legal / en Sat, 26 Apr 2025 13:30:31 -0500 Fri, 27 Oct 23 10:54:48 -0500 AHA Comments on MedPAC's Site-neutral, Nurse Staffing Requirements October 2024 Meeting Discussion /2023-10-27-aha-comments-medpacs-site-neutral-nurse-staffing-requirements-october-2024-meeting-discussion October 27, 2023 Michael Chernew, Ph.D. Chairman Medicare Payment Advisory Commission 425 I Street, NW, Suite 701 Washington, DC 20001 Dear Dr. Chernew: On behalf of our nearly 5,000 member hospitals, health systems and other health care organizations; our clinician partners – including more than 270,000 affiliated physicians, 2 million nurses and other caregivers – and the 43,000 health care leaders who belong to our professional membership groups, the �� Association (AHA) appreciates the opportunity to share our comments on two topics that were discussed during the October 2023 public meeting – “site-neutral” payments to inpatient rehabilitation facilities (IRF) and skilled-nursing facilities (SNFs), and nurse staffing requirements. Specifically, we: <ul> <li>urge the commission to reconsider its pursuit of IRF-SNF site-neutral payment policies; and</li> <li>recommend the commission focus any further study of nurse staffing requirements on their impact on long-term care facility capacity and subsequent access to care.</li> </ul> Our detailed comments on these issues follow. <h2>INPATIENT REHABILITATION FACILITY PAYMENTS</h2> At the October 2023 meeting, the commissioners discussed a potential “site-neutral’ policy for certain conditions treated in IRFs, specifically considering whether conditions that fall outside the 13 that must account for 60% of IRF patients should be paid at the skilled-nursing facility (SNF) rate. The AHA appreciates that MedPAC continues to pursue proposals that could potentially improve the alignment of cost and payment under the IRF prospective payment system (PPS). However, we have numerous concerns about the commission’s analysis; AHA believes a site-neutral policy would ultimately be harmful to seriously afflicted Medicare beneficiaries. Chief among our concerns is that the manner of which MedPAC uses the 60% Rule in payment policy, which represents a fundamental misunderstanding of the IRF exclusion criteria. We urge MedPAC to reconsider its pursuit of IRF-SNF site-neutral payment policies. To begin, and as MedPAC has recognized, any IRF-SNF site-neutral payment policy is rife with potential complications. This is due to the vastly different regulatory environments that IRFs (hospitals) and SNFs (subacute facilities) operate under. The difficulties in aligning payment incentives and other important factors between these and other sites of care became apparent during MedPAC’s work on the Unified Post-Acute Care (UPAC) payment system. As AHA pointed out from the beginning of that work, each post-acute site has its own unique payment and regulatory structure. In addition, and as was noted during the Commission’s discussion, IRFs provide a vastly more intensive course of treatment than SNFs. Further, the Medicare cost sharing, lifetime coverage, and several other factors vary greatly between the two types of facilities. Although perhaps not entirely insurmountable, these factors make any attempt to align payment between the two sites of care a very complex task, which may not be worthy of the Commission’s or Congress’ efforts. We also have serious concerns about the manner in which MedPAC’s site-neutral policy would be tied to the IRF 60% Rule. By applying the 60% Rule to a payment policy, the analysis presented during the Commission’s session fundamentally misconstrued the rule’s utility and purpose. By way of background, the 13 conditions listed as part of the exclusion criteria trace back almost 50 years to 1975, when the initial 10 conditions were selected; they in no way provide a modern-day representation of the typical conditions requiring inpatient rehabilitation.1 The 60% Rule is intended only to serve as a tool that broadly distinguishes IRFs from acute-care hospitals based on patient mix. It is intended to serve neither as an adjunct to determine the appropriateness of IRF level of care, nor in determining whether individual patients are appropriate for IRF care. Since its inception, the rule was updated to account for medical advancements just once – in 2005 – with the addition of 3 more conditions. Yet, in the intervening years, there have been drastic shifts in the types of patients who require and benefit from IRF services. As just a few examples, due to advancement in certain orthopedic procedures, certain post-surgical patients that once frequently required IRF services now rarely do. Conversely, certain oncology patients, once faced with grim survival rates, are now recovering and utilizing IRFs to regain function under close medical supervision in ways not possible in prior decades. Even at the genesis of the IRF 60% Rule, it was recognized that it was a drastic over-generalization that only had utility as a facility classification tool; as such, it has never been used as a coverage or payment rule by Medicare. Indeed, to the contrary, Medicare coverage regulations require that 100% of all Medicare beneficiaries treated in IRFs require intensive rehabilitation – they do not require patients to have any specific&nbsp;conditions.2 In other words, Medicare’s medical necessity rules apply regardless of whether the patient’s condition is one of those included in the 60% Rule or not. This means that even those conditions that MedPAC described as “nonqualifying” actually must, and do, meet the IRF medical necessity criteria. Indeed, these patients are only “nonqualifying” as far as the 60% Rule is concerned – they are actually valid IRF admissions. However, MedPAC is considering a proposal that would utilize the 60% Rule for payment purposes, broadly grouping IRF patients into two categories – “qualifying” and “nonqualifying” – and modifying payment accordingly. Two specific statements made during this session’s presentation stood out as highlighting the fundamental misapplication of the 60% Rule to payment policy. The first was that “the alternative payment method to pay for stays that do not require intensive rehabilitation would rely on Medicare’s definition of qualifying and nonqualifying conditions” (italics added). As stated earlier, CMS is already prohibited by its own medical necessity criteria from paying for any stays that do not require intensive rehabilitation. While it may be true that some conditions do not typically require inpatient rehabilitation, beneficiaries admitted to IRFs are those that do in fact require such a level of care, as demonstrated by meeting the stated medical necessity requirements. Therefore, the main premise of MedPAC’s proposal, that some patients currently admitted to IRFs do not require intensive rehabilitation, is false. The aforementioned misunderstanding led to the second comment that stood out to AHA, which was the main prompt of this policy discussion: “Nonqualifying conditions typically do not require the intensive rehabilitation care that is unique to IRFs. This raises the question: What is Medicare buying for the higher payment rates?” The answer to this question lies in the patient-centric nature of the IRF admissions process. IRFs are required by regulation to undergo a rigorous preadmission screening process for every patient, which includes an evaluation overseen by a specialized physician to determine whether the patient is appropriate for intensive rehabilitation.3 This is why, consistent with the perception that nonqualifying conditions do not typically require intensive rehabilitation, IRFs accept a relative low percentage of referrals with nonqualifying conditions. The differences in patients who can benefit from IRF care and those who are better treated in a SNF are often very nuanced and difficult to capture on standardized patient assessment&nbsp;data. To be clear, while it may appear on paper that many patients are the same or similar, every single patient is unique. This is why it is left to the experience and training of the clinicians and case managers who must account for numerous medical, functional and social factors to determine the optimal placement for patients. These clinicians and experts must account for all of these factors and offer recommendations as to an appropriate placement for post-acute care. Maximizing outcomes for Medicare patients on the road to recovery after a serious injury or illness is far from a precise science, but instead requires the input of multiple clinical disciplines, input from patients and their families, and knowledge of the capabilities of the available sites of post-acute care. The preadmission screening process utilized by IRFs is a patient-centric approach to post-acute placement that is precisely what Medicare beneficiaries should expect. By closely evaluating the specifics of each patient’s medical, functional and social factors, it ensures that those patients who do not require IRF services are placed elsewhere, while those in need of intensive rehabilitation are able to benefit from those services, receiving the best possible care. Yet, the approach that MedPAC is suggesting would substitute this patient-centric approach for a one-size-fits-all categorization that would broadly group all patients outside the 13 conditions into a “nonqualifying” class, despite their widely varying needs. Further, IRFs would be deeply disincentivized from taking these nonqualifying cases, which would restrict patients from accessing needed IRF care while recovering from serious ailments related to cardiac events, cancer and even COVID-19. In addition to a lack of patient-centric analysis, the discussion failed to appreciate the current dynamics of the IRF PPS and how it already captures variation in resource use among different types of conditions. Under the current payment system, as is the case with all of the PPSs, CMS analyzes the relative resource use of each diagnosis group (referred to as case-mix groups, or CMGs under the IRF PPS) and assigns a relative weight. Through this design, the agency is already accounting for those types of patients that require varying intensities of care; payments are adjusted accordingly. The approach that MedPAC is suggesting – grouping 40% of IRF patients into a “nonqualifying group,” based upon an erroneous criteria – would be a far less precise and accurate system than the one that currently exists. To return to the primary discussion question for this session (“What is Medicare paying for?”), we encourage MedPAC to keep in mind the hundreds of thousands of seriously afflicted Medicare beneficiaries that benefit from IRF services every year. As the MedPAC analysis pointed out, the length of stay in IRFs is less than half that in SNFs, with well more than twice as much therapy, all while in a closely medically supervised, hospital setting. These patients are often facing more serious functional deficits, have more complex medical needs, or face other factors that make treatment in a less intensive setting suboptimal. Therefore, what Medicare is paying for includes: functional and medical outcomes that could not be achieved elsewhere; fewer complications and readmissions than would be the case if these patients were treated in SNFs; and a quicker return to home. All of this results in savings to the Medicare program. As discussed before, disincentivizing the use of IRFs for a broad range of patient types based on the IRF classification criteria would be a grave disservice to both these beneficiaries and the Medicare program; such a policy would not advance the mission of delivering high quality, efficient care to beneficiaries. Therefore, the AHA strongly urges MedPAC to reconsider its pursuit of an IRF-SNF site neutral payment policy. We appreciate the commission’s efforts to ensure that payment is properly aligned with costs. We would be happy to work with your staff to discuss our concerns. <h2>EXAMINING STAFFING RATIOS AND TURNOVER IN NURSING FACILITIES</h2> Also at the October 2023 meeting, commissioners received an overview of the literature available on the relationship between nursing facility staffing and quality of care, as well as the wide variation in federal and state staffing requirements. Staff also reviewed key provisions of CMS’ recent proposed rule that would impose minimum staffing standards on long-term care (LTC) facilities. Staff noted that they plan to analyze staffing data in the SNF payment adequacy chapter in the March 2024 report and include an informational chapter with updated staffing analysis in the June 2024 report; commissioners discussed what additional work staff should take on regarding minimum staffing requirements and other policy options to improve staffing. The AHA and its members are committed to safe staffing to ensure high quality, safe, equitable and patient-centered care in all health care settings, including LTC facilities. However, we echo the concerns of several MedPAC commissioners that CMS’ proposal to implement mandatory nurse staffing levels is an overly simplistic approach to a complex issue that, if implemented, would have serious negative unintended consequences for not only nursing home patients and facilities, but the entire health care continuum. Substantial evidence exists demonstrating the conceptual weakness of numerical nurse staffing thresholds to promote high-quality care; other data shows that these types of requirements would have detrimental effects on the nurse workforce throughout the care continuum. We encourage MedPAC to focus its analyses on staffing on the effects minimum staffing requirements have had on facility capacity and, subsequently, patient access to care, including likely effects on discharge delays from general acute care hospitals. Prior to the COVID-19 pandemic, health care providers were already facing significant challenges making it difficult to sustain, build and retain the health care workforce. In 2017, the majority of the nursing workforce was close to retirement, with more than half aged 50 and older, and almost 30% aged 60 and older. These shortages only accelerated due to the profound disruptive impacts of the COVID-19 pandemic. Indeed, according to a 2022 study in Health Affairs, the total supply of RNs decreased by more than 100,000 from 2020 to 2021 — the largest drop observed over the past four decades.4 An even more&nbsp;comprehensive analysis from a large-scale biennial survey conducted by the National Council of State Boards of Nursing (NCSBN) and National Forum of State Nursing Workforce Centers (NFSNWC) found a similar number of registered nurses had left the workforce. It also showed that nearly 900,000 — or one-fifth of the 4.5 million total registered nurses — expressed an intention to leave the workforce due to stress, burnout and retirement. The NCSBN and NFSNWC study also noted that over 33,800 licensed practical nurses (LPNs) and vocational nurses left the field since 2020, disproportionately impacted nursing homes and LTC facilities.5 Unfortunately, our nation’s ability to replace those nurses choosing to exit the field is also severely constrained. Indeed, the American Association of Colleges of Nursing notes that nursing schools have struggled for more than a decade to increase enrollments due primarily to an insufficient number of faculty and available clinical placement opportunities for students.6 In fact, in 2022 the number of students in entry-level baccalaureate nursing programs decreased by 1.4%, the first time in 20 years in which schools have been unable to increase enrollment.7 In its proposed rule, CMS estimates that 75% of LTC facilities would have to increase staffing to meet the proposed standards, including the new standard requiring 24/7 RN staffing. Another study from the Kaiser Family Foundation estimated that 81% would need to hire more RNs or NAs.8 We suggest that MedPAC investigate the direct and indirect costs on not only LTC facilities, but the entire health care continuum as a result of this increased staffing. For example, a 2022 study estimated that staffing shortages will potentially cost nursing and rehabilitation facilities, as well as home-health agencies, $19.5 billion per year.9 Considering the finite availability of the nursing workforce, these costs will certainly be felt beyond nursing and rehabilitation facilities, and MedPAC can look further into these costs and the consequences of increased spending on staffing without clear ties to improved patient outcomes. Further, faced with required staffing levels, we anticipate skilled nursing facilities and other LTC facilities may be forced to reduce their capacity or even close their doors when they are unable to meet these mandates. Organizations considering opening new LTC facilities would likely be discouraged from doing so knowing they may not be able to recruit enough staff to meet CMS’ thresholds. This would have a ripple effect across the entire continuum&nbsp;of care, as general acute care hospitals, inpatient rehabilitation facilities and other health care facilities already struggle to find appropriate placement for their patients. Indeed, hospitals and health systems already are experiencing significant challenges in moving patients through the health care continuum generally, and into skilled nursing facility care specifically. The average length-of-stay (ALOS) in hospitals for all patients increased 19.2% in 2022 compared to 2019 levels; for patient being discharged to post-acute care providers, the ALOS increased nearly 24% in the same period. Case-mix index-adjusted ALOS increased for patients being discharged from acute care hospitals to skilled nursing facilities by 20.2%.10 These longer stays in hospitals are not a mere inconvenience. They result in delays in patients receiving the next level of medically necessary care. They also lead to longer wait times in hospital emergency departments because hospitals are unable to move current patients out of inpatient beds. In other words, constrained access to LTCs is a quality-of-care issue affecting all types of patients across the care continuum. In part, the above trends reflect the significant shortages of health care workers experienced in skilled nursing and other long-term care facilities. But they also reflect an alarming increase in LTC facility closures across the country, a trend that could be accelerated if CMS’ proposed rule is adopted. Since the beginning of 2020, at least 600 LTC facilities have closed while only three have opened so far in 2023 (compared to an average of 64 opening each year from 2020 to 2022).11 We suggest that MedPAC include metrics like closures, wait times, ALOS, and discharge delays in their future analyses of the effects of minimum staffing requirements. We thank you for your consideration of our comments. Please contact me if you have questions or feel free to have a member of your team contact Shannon Wu, AHA’s senior associate director of policy, at <a href="mailto:mailto:swu@aha.org">swu@aha.org</a> or 202-626-2963. Sincerely, /s/ Ashley B. Thompson Senior Vice President Public Policy Analysis and Development Cc: Paul Masi, M.P.P. MedPAC Commissioners __________ 1 Medicare Program; Prospective Payment for Medicare Inpatient Hospital Services, 49 Fed. Reg. 239 (Jan. 3, 1984). 2 The other medical necessity requirements, found at 42. C.F.R. 42 § 412.622, These medical necessity includes requiring at least 15 hours of therapy per week, a multiple disciplinary approach to care, close physician supervision, rehabilitation nursing, and several others. 3 The preadmission screening requirement at 42 C.F.R. § 412.622(a)(4)(i) must be conducted by a licensed clinician within 48 hours of admission, include a detailed review of the patient’s condition, history, prior and expected level of function, expected level of improvement, expected duration of treatment, evaluation of patient’s risk for complications, conditions causing the need for rehabilitation, the detailed therapies needed by the patient, and the discharged expectations for the patient. The rehabilitation physician at the IRF must review and concur with the findings of this screening. 4 Auerbach, David, et al. “A Worrisome Drop in the Number of Young Nurses,” Health Affairs Forefront, April 13, 2022. <a href="https://www.healthaffairs.org/content/forefront/worrisome-drop-number-young-nurses" target="_blank">https://www.healthaffairs.org/content/forefront/worrisome-drop-number-young-nurses</a> 5<a href="http://https://www.journalofnursingregulation.com/article/S2155-8256(23)00047-9/fulltex" target="_blank"> https://www.journalofnursingregulation.com/article/S2155-8256(23)00047-9/fulltex</a>t 6 American Association of Colleges of Nursing, Fact Sheet: Nursing Shortage. October, 2022 <a href="https://www.aacnnursing.org/Portals/0/PDFs/Fact-Sheets/Nursing-Shortage-Factsheet.pdf" target="_blank">https://www.aacnnursing.org/Portals/0/PDFs/Fact-Sheets/Nursing-Shortage-Factsheet.pdf</a> 7 <a href="https://www.aacnnursing.org/news-data/all-news/new-data-show-enrollment-declines-in-schools-of-nursing-raising-concerns-about-the-nations-nursing-workforce" target="_blank">https://www.aacnnursing.org/news-data/all-news/new-data-show-enrollment-declines-in-schools-of-nursing-raising-concerns-about-the-nations-nursing-workforce</a> 8 Burns, Alice, et al. “What Share of Nursing Facilities Might Meet Proposed New Requirements for Nursing Staff Hours?” Kaiser Family Foundation, September 18, 2023. <a href="https://www.kff.org/medicaid/issue-brief/what-share-of-nursing-facilities-might-meet-proposed-new-requirements-for-nursing-staff-hours/#:~:text=Finally%2C%20the%20rule%20was%20announced,improve%20enforcement%20of%20existing%20standards" target="_blank">https://www.kff.org/medicaid/issue-brief/what-share-of-nursing-facilities-might-meet-proposed-new-requirements-for-nursing-staff-hours/#:~:text=Finally%2C%20the%20rule%20was%20announced,improve%20enforcement%20of%20existing%20standards </a> 9 “Staffing shortages to cost U.S. care facilities $19.5 billion this year, study finds.” Bloomberg, June 2, 2022<a href="https://fortune.com/well/2022/06/02/staffing-shortages-to-cost-us-care-facilities-19-5-billion-this-year-study-finds/" target="_blank">. https://fortune.com/well/2022/06/02/staffing-shortages-to-cost-us-care-facilities-19-5-billion-this-year-study-finds/</a> 10 AHA Issue Brief, December 2022. 11 “The Upheaval at America’s Disappearing Nursing Homes, in Charts,” Wall Street Journal, August 23, 2023.<a href="https://www.wsj.com/health/healthcare/the-upheaval-at-americas-disappearing-nursing-homes-in-charts-9aa8d2f9" target="_blank"> https://www.wsj.com/health/healthcare/the-upheaval-at-americas-disappearing-nursing-homes-in-charts-9aa8d2f9</a> Fri, 27 Oct 2023 10:54:48 -0500 Legal Litigation /legal/litigation This page contains materials related to AHA’s current and active policy-related litigation. <hr /> <div class="col-md-12 cc_tabs">Get CertifiedRecertify</div> --&gt; <div class="tabcontent" id="General"> <div class="tabcontent" id="General"> <ul class="a-container"> <li class="a-items"> No Surprises Act Regulation <div class="a-content"> <a href="/legal-documents/2021-12-10-hospital-and-physician-groups-file-lawsuit-over-no-surprises-act-final" target="_blank">AHA, AMA and Others on No Surprises Act Rule That Jeopardizes Patient Access to Care</a> <ul> <li><a href="/system/files/media/file/2021/12/Opposition-to-Briefing-Schedule.pdf">AHA, AMA, Hospitals/Physicians Oppose Govt’s proposed briefing schedule (Dec. 15, 2021) </a></li> <li><a href="/system/files/media/file/2021/12/Mot-to-Establish-Briefing-Schedule.pdf">Govt’s Motion to establish briefing schedule (Dec. 14, 2021)</a></li> <li><a href="/system/files/media/file/2021/12/Hospital-Association-Amicus-Brief.pdf">National Hospital Associations amicus brief supporting AHA’s No Surprises Act legal challenge (Dec. 15, 2021)</a></li> <li><a href="/system/files/media/file/2021/12/AMA-v-HHS-As-Filed-Complaint.pdf">Complaint for Declaratory and Injunctive Relief</a> (December 9, 2021)</li> <li><a href="/system/files/media/file/2021/12/AMA-v-HHS-As-Filed-Stay-Motion-and-Brief.pdf">Plaintiffs Motion for Stay Pending Judicial Review, Or in the Alternative, For Summary Judgment</a> (December 9, 2021)</li> <li><a href="/system/files/media/file/2021/12/AMA-v-HHS-As-Filed-Sexton-Declaration.pdf">Declaration of Bethany Sexton (Renown Health) in Support of Plaintiffs Motion for Preliminary Injunction</a> (December 9, 2021)</li> <li><a href="/system/files/media/file/2021/12/AMA-v-HHS-As-Filed-Rossi-Declaration.pdf">Declaration of Catherine M. Rossi (UMass Memorial Health) in Support of Plaintiffs’ Motion for Stay Pending Judicial Review, or in the Alternative, a Preliminary Injunction</a> (December 9, 2021)</li> </ul> </div> <ul class="a-container"> <li class="a-items"> 340B Contract Pharmacy – Intervention <div class="a-content"> NOVO NORDISK v Cochran <ul> <li><a href="/2021-06-24-amicus-brief-novo-nordisk-v-cochran-re-340b-contract-pharmacy-intervention">Amicus Brief NOVO NORDISK v Cochran </a>(June 22, 2021)</li> <li><a href="/legal-documents/2021-03-31-reply-support-motion-intervene-novo-nordisk-v-cochran-march-29-2021">Reply in Support of Motion to Intervene </a>(March 29, 2021)</li> <li><a href="/legal-documents/2021-03-31-response-motion-intervene-novo-nordisk-v-cochran-march-22-2021">Response to Motion to Intervene </a>(March 22, 2021)</li> <li><a href="/legal-documents/2021-03-27-notice-and-memorandum-support-motion-intervene-sanofi-aventis-vs-hhs">Motion and Memorandum in Support of Motion to Intervene </a>(March 2, 2021)</li> </ul> &nbsp; SANOFI-AVENTIS v HHS <ul> <li><a href="/legal-documents/2021-11-05-court-opinion-sanofi-aventis-us-llc-and-novo-nordisk-challenges-340b">Court Opinion in Sanofi-Aventis U.S., LLC, and Novo Nordisk challenges to 340B Contract Pharmacies Obligations </a>(November 5, 2021)</li> <li><a href="/legal-documents/2021-03-29-associations-reply-support-motion-intervene-sanofi-aventis-vs-hhs-march">Associations’ Reply in Support of Motion to Intervene </a>(March 29, 2021)</li> <li><a href="/legal-documents/2021-03-26-response-motion-intervene-sanofi-aventis-vs-hhs-march-22-2021">Response to Motion to Intervene </a>(March 22, 2021)</li> <li><a href="/legal-documents/2021-03-27-notice-and-memorandum-support-motion-intervene-sanofi-aventis-vs-hhs">Notice and Memorandum in Support of Motion to Intervene </a>(March 3, 2021)</li> </ul> &nbsp; AstraZeneca v. Cochran <ul> <li><a href="/system/files/media/file/2021/05/05-04-21-Docket-No-54-AHA-et-al-Amicus-Brief.PDF">Amicus Brief of Associations in Support of the Government</a> (May 4, 2021)</li> <li><a href="/system/files/media/file/2021/05/05-04-21-Docket-No-56-Gov-Brief-in-Support-of-MTD_MSJ.PDF">Government’s Brief in Support of Motion to Dismiss or, Alternatively, Motion for Summary Judgment and Opposition to Plaintiff’s Motion for Summary Judgment</a> (May 4, 2021)</li> <li><a href="/legal-documents/2021-03-27-associations-reply-support-motion-intervene-astrazeneca-v-cochran-march">Associations’ Reply in Support of Motion to Intervene </a> (March 19, 2021)</li> <li><a href="/legal-documents/2021-03-27-astrazenecas-opposition-motion-intervene-astrazeneca-v-cochran-march-12">AstraZeneca’s Opposition to Motion to Intervene </a> (March 12, 2021)</li> <li><a href="/amicus-brief/2021-03-27-governments-opposition-motion-intervene-astrazeneca-v-cochran-march-12-2021">Government’s Opposition to Motion to Intervene </a> (March 12, 2021)</li> <li><a href="/system/files/media/file/2021/03/motion-to-intervene-astrazeneca-v-cochran-2-26-21-340b-contract-pharmacy-intervention.pdf">Motion to Intervene – AstraZeneca v. Cochran</a> (Feb. 26, 2021)</li> </ul> &nbsp; Eli Lilly v. Cochran <ul> <li><a href="/legal-documents/2021-11-01-court-decision-lilly-challenge-october-29-2021">Court Decision on the Lilly Challenge </a>(October 29, 2021)</li> <li><a href="/legal-documents/2021-11-01-court-order-lilly-challenge-october-29-2021">Court Order in the Lilly Challenge </a>(October 29, 2021)</li> <li><a href="/legal-documents/2021-03-26-associations-reply-support-motion-intervene-eli-lilly-v-cochran-march-19">Amicus Brief Eli Lilly v Cochran </a>(June 23, 2021)</li> <li><a href="/legal-documents/2021-03-26-associations-reply-support-motion-intervene-eli-lilly-v-cochran-march-19">Associations’ Reply in Support of Motion to Intervene </a>(March 19, 2021)</li> <li><a href="/legal-documents/2021-03-26-governments-opposition-motion-intervene-eli-lilly-v-cochran-march-9-2021">Government’s Opposition to Motion to Intervene </a>(March 9, 2021)</li> <li><a href="/system/files/media/file/2021/02/motion-to-intervene-340B-contract-pharmacy-2-19-21.pdf">Motion to Intervene </a> (Feb. 19, 2021)</li> <li><a href="/system/files/media/file/2021/02/memorandum-in-support-of-motion-to-intervene-340b-contract-pharmacy-2-19-21.pdf">Memorandum in Support of Motion to Intervene </a> (Feb. 19, 2021)</li> </ul> <h4>Additional Drug Manufacturers Challenges to 340B Contract Pharmacy Obligations</h4> Novartis/United Therapeutics v ESPINOSA <ul> <li><a href="/legal-documents/2021-11-05-court-order-novartisunited-therapeutics-challenges-340b-contract">Court Order Novartis/United Therapeutics Challenges to 340B Contract Pharmacies Obligations </a> (Nov.5, 2021)</li> <li><a href="/legal-documents/2021-11-05-court-opinion-novartisunited-therapeutics-challenges-340b-contract">Court Opinion in Novartis/United Therapeutics Challenges to 340B Contract Pharmacies Obligations </a> (Nov.5, 2021)</li> </ul> </div> <ul class="a-container"> <li class="a-items"> 340B Contract Pharmacy <div class="a-content"> <a href="/system/files/media/file/2021/02/order-granting-motion-to-dismiss-re-340b-contract-pharmacy-2-17-21.pdf">Order Granting Motion to Dismiss</a> (Feb. 17, 2021) <a href="/system/files/media/file/2021/02/plaintiffs-response-order-show-cause-opposition-to-defendants-motion-dismiss-reply-support-plaintiffs-motion-for-preliminary-injunction-340b-contract-pharmacy-1-25-21.pdf">Plaintiffs' Response to Order to Show Cause, Opposition to Defendants' Motion to Dismiss, and Reply in Support of Plaintiffs' Motion for a Preliminary Injunction</a> (Jan. 25, 2021) <a href="/system/files/media/file/2021/02/order-to-show-cause-re-dismissal-for-lack-of-subject-matter-jurisdiction-340b-contract-pharmacy-1-13-21.pdf">Order to show Cause RE: Dismissal for Lack of Subject-Matter Jurisdiction</a> (Jan. 13, 2021) <a href="/system/files/media/file/2020/12/associations-hospitals-complaint-compel-hhs-action-address-340b-contract-pharmacy-issue-12-11-20.pdf">Associations and Hospitals Complaint to compel HHS Action to Address 340B Contract Pharmacy Issue</a> (Dec. 11, 2020) <ul> <li><a href="/system/files/media/file/2020/12/associations-hospitals-motion-preliminary-injunction-hhs-action-to-address-340b-contract-pharmacy-issue%20-12-11-20.pdf">Associations and Hospitals Motion for Preliminary Injunction </a>(Dec. 11, 2020)</li> <li><a href="/system/files/media/file/2020/12/summons-re-associations-hospitals-complaint-compel-hhs-action-address-340b-contract-pharmacy-issue-12-11-20.pdf">Summons to HHS </a> (Dec. 11, 2020)</li> </ul> </div> </li> <li class="a-items"> Disclosure of Negotiated Charges <div class="a-content"> <a href="/legal-documents/2020-12-24-reply-support-appellants-emergency-motion-stay-december-24-2020">Reply in Support of Appellants’ Emergency Motion for Stay</a> (December 24, 2020) <a href="/system/files/media/file/2020/12/2020-12-23-Appellee-US-Opposition-to-Emergency-Motion-to-Stay.pdf">Appellee U.S. Opposition to Emergency Motion to Stay</a> (December 23, 2020) <a href="/legal-documents/2020-12-21-hospitals-emergency-motion-stay-re-disclosure-negotiated-rates">Hospitals’ Emergency Motion for Stay </a>(December 21, 2020) <ul> <li><a href="/system/files/media/file/2020/12/hospitals-emergency-motion-for-stay-disclosure-of-negotiated-rates-12-21-2020-ex-1.pdf">Exhibit 1</a></li> <li><a href="/system/files/media/file/2020/12/hospitals-emergency-motion-for-stay-disclosure-of-negotiated-rates-12-21-2020-ex-2.pdf">Exhibit 2</a></li> <li><a href="/system/files/media/file/2020/12/hospitals-emergency-motion-for-stay-disclosure-of-negotiated-rates-12-21-2020-ex-3.pdf">Exhibit 3</a></li> </ul> <a href="/legal-documents/2020-10-02-hospital-group-responds-governments-notice-about-recent-guidance-oct-2">Hospital Group Responds to Government’s Notice About Recent Guidance </a>(October 2, 2020) <a href="/legal-documents/2020-10-02-government-notifies-court-recently-released-guidance-negotiated-charges">Government Notifies Court of Recently Released Guidance on Negotiated Charges Rule Implementation </a>(October 1, 2020) <a href="/legal-documents/2020-10-02-government-responds-hospital-group-letter-executive-order-oct-1-2020">Government Responds to Hospital Group Letter on the Executive Order </a>(October 1, 2020) <a href="/legal-documents/2020-09-28-hospital-group-notifies-court-recent-price-transparency-executive-order">Hospital Group Notifies Court of Recent Price Transparency Executive Order </a>(September 25, 2020) <a href="/legal-documents/2020-09-28-govt-responds-hospital-groups-previous-notice-court-re-additional">Govt. Responds to Hospital Groups’ Previous Notice to the Court about Additional Disclosure Required In 2021 IPPS Final Rule </a>(September 25, 2020) <a href="/legal-documents/2020-09-21-hospital-group-notifies-court-relevant-supplemental-authority-re">Hospital Group Notifies Court of Relevant Supplemental Authority </a>(September 21, 2020) <a href="/legal-documents/2020-08-28-hospital-groups-reply-government-re-disclosure-negotiated-charges-august">Hospital Groups Reply to Government </a>(August 28 2020) <a href="/legal-documents/2020-08-14-governments-reply-brief-negotiated-charges-appeal-august-14-2020">Government’s Reply Brief In Negotiated Charges Appeal</a> (August 14, 2020) <a> </a> <a href="/amicus-brief/2020-07-24-hospital-associations-amicus-brief-negotiated-charges-appeal-july-24-2020">Hospital Associations Amicus Brief in Negotiated Charges Appeal</a> (July 24, 2020) <a href="/amicus-brief/2020-07-24-us-chamber-amicus-brief-negotiated-charges-appeal-july-24-2020">US Chamber Amicus Brief in Negotiated Charges Appeal</a> (July 24, 2020) <a href="/amicus-brief/2020-07-24-hfma-amicus-brief-negotiated-charges-appeal-july-24-2020">HFMA Amicus Brief in Negotiated Charges Appeal</a> (July 24, 2020) <a href="/legal-documents/2020-07-17-opening-appeals-brief-re-disclosure-negotiated-charges-july-17-2020">Opening Appeals Brief</a> (July 17, 2020) <a href="/legal-documents/2020-07-06-dc-circuits-order-adopting-aha-recommended-expedited-briefing-schedule">D.C. Circuit’s Order Adopting AHA Recommended Expedited Briefing Schedule for Appeal</a> (July 7, 2020) <a href="/legal-documents/2020-07-06-motion-expedite-appeal-july-3-2020">Motion to Expedite Appeal</a>&nbsp;(July 3, 2020) <a href="/legal-documents/2020-06-24-notice-appeal-court-decision-public-disclosure-negotiated-rates-june-23">Notice of Appeal</a> (June 23, 2020) <a href="/legal-documents/2020-06-23-court-decision-disclosure-negotiated-charges-lawsuit-june-23-2020">Court Decision in Disclosure of Negotiated Charges Lawsuit</a> (June 23, 2020) <a href="/legal-documents/2020-04-28-governments-reply-brief-disclosure-negotiated-charges-lawsuit-march-24">Government’s Reply Brief in Disclosure of Negotiated Charges Lawsuit</a> (March 24, 2020) <a href="/system/files/media/file/2020/03/court-sets-april-22-hearing-date-aha-challenge-to-rule-requiring-hospitals-disclose-negotiated-charges-3-5-2020.pdf">Court Sets April 22 Hearing Date in AHA’s Challenge to the Rule Requiring Hospitals to Disclose Negotiated Charges</a> (March 5., 2020) <a href="/system/files/media/file/2020/03/us-chamber-commerce-files-amicus-brief-supporting-legal-challenge-rule-requiring-disclosure-of-negotiated-charges-2-28-2020.pdf">US Chamber of Commerce Files Amicus Brief Supporting Legal Challenge to Rule Requiring Disclosure of Negotiated Charges</a> (Feb. 28. 2020) <a href="/system/files/media/file/2020/03/aha-reply-brief-case-to-prevent-disclosure-negotiated-contracts-2-28-2020.pdf">AHA Reply Brief in Case to Prevent Disclosure of Negotiated Contracts</a> (Feb. 28, 2020) <a href="/legal-documents/2020-02-28-amicus-brief-37-state-hospital-associations-support-plaintiffs-motion">Amicus Brief of the State Hospital Associations in Support of AHA Lawsuit Challenging Disclosure of Negotiated Charges Rule</a> (Feb. 28, 2020) <a href="/system/files/media/file/2020/02/government-moves-for-summary-judgement-in-disclosure-of-negotiated-charges-lawsuit-2-4-2020.pdf">Government Moves for Summary Judgement in Disclosure of Negotiated Charges Lawsuit</a> (Feb. 4, 2020) <a href="/system/files/media/file/2019/12/scheduling-order-signed-by-judge-nichols-12-18-19.pdf">Scheduling Order Signed by Judge Nichols</a> (Dec. 18, 2019) <a href="/system/files/media/file/2019/12/joint-motion-for-scheduling-order-disclosure-of-negotiated-charges-12-13-19-.pdf">Joint Motion for Scheduling Order</a> (December 13, 2019) <a href="/system/files/media/file/2019/12/aha-hospital-group-brief-in-support-of-their-motion-for-summary-judgment-disclosure-of-negotiated-charges-12-9-19.pdf">AHA, Hospital Group Brief in Support of Their Motion for Summary Judgment</a> (Dec. 9, 2019) <a href="/system/files/media/file/2019/12/hospital-groups-lawsuit-over-illegal-rule-mandating-public-disclosure-individually-negotiated-rates-12-4-19.pdf%20.pdf">Hospital Groups File Lawsuit Over Illegal Rule Mandating Public Disclosure of Individually Negotiated Rates</a>, December 4, 2019 </div> </li> <li class="a-items"> Site Neutral Payment Policy <div class="a-content"> <a href="/legal-documents/2021-05-28-aha-reply-government-related-petition-cert-us-supreme-court-site-neutral">AHA Reply to Government Related to Petition for Cert at US Supreme Court (May 28, 2021)</a> <a href="/system/files/media/file/2021/02/amicus-brief-state-regional-hosp-associations-site-neutral-2-23-21.pdf">Amicus Brief-State and Regional Hospital Associations</a> (Feb. 23, 2021) <a href="/legal-documents/2021-02-10-aha-asks-us-supreme-court-hear-case-hospital-outpatient-payment-cuts">AHA Asks U.S. Supreme Court to Hear Case Hospital Outpatient Payment Cuts</a> (Feb. 10, 2021) <a href="/legal-documents/2020-12-11-joint-status-report-court-re-site-neutral-lawsuit-dec-11-2020">Joint Status Report to the Court</a> (Dec. 11, 2020) <a href="/legal-documents/2020-08-31-hospital-groups-petition-rehearing-re-site-neutral-payment-policy-august">Hospital Groups Petition for Rehearing Re: Site Neutral Payment Policy</a> (August 31, 2020) <a href="/system/files/media/file/2020/07/site-neutral-decision-appeals-court-7-17-20.pdf">Decision from the Appeals Court Re: Site Neutral Payment Policy</a> (July 17, 2020) <a href="/system/files/media/file/2020/03/government-reply-in-the-site-neutral-2020-lawsuit-march-12-2020.pdf">Government’s Reply in the Site Neutral 2020 Lawsuit</a> (March 12, 2020) <a href="/system/files/media/file/2020/03/government-reply-in-appeal-of-its-site-neutral-loss-3-11-2020.pdf">Government’s Reply in Appeal of Its Site Neutral Loss</a> (March 11, 2020) <a href="/system/files/media/file/2020/03/aha-responds-governments-opposition-brief-cross-motion-2020-site-neutral-rulemaking-challenge.pdf">AHA Responds to the Government’s Opposition Brief/Cross-Motion in the 2020 Site Neutral Rulemaking Challenge</a> (March 3, 2020) <a href="/system/files/media/file/2020/03/governments-opposition-brief-cross-motion-in-2020-site-neutral-rulemaking-challenge-feb-18-2020.pdf">Government’s Opposition Brief/Cross-Motion in the 2020 Site Neutral Rulemaking Challenge</a> (Feb 18, 2020) <a href="/legal-documents/2020-02-21-appeals-court-urged-reject-cms-argument-outpatient-payment-case">Appeals Court Urged to Reject CMS Argument in Outpatient Payment Case</a> (Feb. 20, 2020) <a href="/legal-documents/2020-02-11-order-court-sets-oral-argument-date-april-17-governments-appeal-its-loss">Court Sets oral Argument Date of April 17 in the Government’s Appeal of Its Loss on Site-Neutral Payment Reduction</a> (Feb. 10, 2020) <a href="/legal-documents/2020-02-03-2020-site-neutral-amended-complaint-feb-2-2020">2020 Site Neutral Amended Complaint</a>&nbsp; (Feb. 2, 2020) <a href="/legal-documents/2020-02-03-2020-site-neutral-summary-judgment-brief-feb-2-2020">2020 Site Neutral Summary Judgment Brief</a> (Feb. 2, 2020) <a href="/system/files/media/file/2020/01/government-initial-brief-in-appeal-of-aha-aamc-hospitals-site-neutral-win-1-23-2020.pdf">Government’s Initial Brief in Their Appeal of AHA, AAMC and Hospitals’ Site Neutral Win</a> (Jan. 23, 2020) <a href="/system/files/media/file/2020/01/Site-neutral-2020-complaint.pdf">Site Neutral 2020 Complaint</a> (Jan. 13, 2020) <a href="/system/files/media/file/2020/01/briefing-schedule-site-neutral.pdf">Briefing schedule in the goverment's appeal of its loss in AHA, AAMC and hospital’s challenge to site neutral payment reduction</a> (Dec. 18, 2019). <a href="/system/files/media/file/2019/12/court-decision-motion-to-enforce-site-neutral-payments-12-16-19.pdf">Court Decision on Motion to Enforce</a> (Dec. 16, 2019) <a href="/system/files/media/file/2019/12/government-notice-appeal-of-site-neutral-court-ruling-that-favored-hospitals.pdf">Government Notice of Its Appeal of Site Neutral Court Ruling that Favored Hospitals</a>&nbsp;(December 12, 2019) <a href="/system/files/media/file/2019/12/cms-will-repay-2019-outpatient-payment-cut-as-result-of-aha-lawsuit-12-12-19.pdf">CMS Will Repay 2019 Outpatient Payment Cut as a Result of AHA Lawsuit</a> (December 12, 2019) <a href="/system/files/media/file/2019/12/supplemental-notice-support-motion-to-enforce-site-neutral-12-9-19.pdf">Supplemental Notice In Support of Motion to Enforce</a> (December 12, 2019) <a href="/system/files/media/file/2019/12/aha-aamc-hospitals-respond-in-support-their-motion-to-enforce-courts-judgment-12-5-19.pdf">AHA, AAMC and Hospitals Respond in Support of Their Motion to Enforce the Court’s Judgment </a>(December&nbsp;5, 2019) <a href="legal-documents/2019-11-25-united-states-governments-response-aha-aamc-and-hospitals-motion-enforce">United States Government’s Response to AHA, AAMC and Hospitals Motion to Enforce Court’s Judgment</a>, November 25, 2019 <a href="/system/files/media/file/2019/11/plaintiffs-motion-to-enforce-judgment-site-neutrasl-11-11-19.pdf">Plaintiffs’ Motion to Enforce Judgment</a>, November 11, 2019 <a href="/system/files/media/file/2019/11/memorandum-in-support-of-plaintiffs-motion-to-enforce-judgment-site-neutal-11-11-19.pdf">Memorandum In Support of Plaintiffs’ Motion to Enforce Judgment</a>, November 11, 2019 <a href="/system/files/media/file/2019/11/minute-order-site-neutral-11-12-19.pdf">Court Sets Briefing Schedule on Our Motion to Enforce the Court's Judgment in the Case (Nov. 12, 2019)</a> <a href="/system/files/media/file/2019/11/government-response-aha-aamc-hospitals-notice-intent-enforce-courts-order-vacating-site-neutral-payment-reduction.pdf">Government’s Response to AHA, AAMC and Hospitals’ Notice of Intent to Enforce Court’s Order Vacating Site Neutral Payment Reduction</a>, November 7, 2019 <a href="/system/files/media/file/2019/11/notice-intent-file-motion-enforce-judgment-request-briefing-schedule-site-neutral-11-7-2019.pdf">Notice of Intent to File Motion to Enforce Judgment and Request for Briefing Schedule</a>, November 6, 2019 <a href="/system/files/media/file/2019/11/proposed-order-setting-briefing-schedule-plaintiffs-motion-enforce-judgment-site-neutral-11-7-19.pdf">Proposed Order Setting the Briefing Schedule For Plaintiffs’ Motion to Enforce Judgment</a>, November 6, 2019 <a href="/system/files/media/file/2019/10/courts-final-order-closing-the-case-site-neutral-litigation-10-21-2019.pdf">Court’s Final Order Closing the Case</a>, October 21, 2019 <a href="/system/files/media/file/2019/10/memorandum-opinion-dckt-38-0-site-neutral-payment-10-21-2019.pdf">Court Will Neither Modify Nor Stay The Order Vacating The Rule’s Provisions</a>, October 21, 2019 <a href="/system/files/media/file/2019/10/site-neutral-government-remedy-reply-19-07-2019.pdf">Government Remedy Reply</a> (October 7, 2019) <a href="/system/files/media/file/2019/10/joint-status-report-site-neutral-10-1-2019.pdf">Joint Status Report</a> (Oct. 1, 2019) <a href="/system/files/media/file/2019/10/aha-aamc-hospitals-opposition-to-governments-motion-to-modify-order-vacating-rules-provision-9-30-2019.pdf">AHA, AAMC, Hospitals Opposition to Government’s Motion to Modify Order Vacating Rule’s Provision</a> (Sept. 30, 2019) <a href="/system/files/media/file/2019/09/government-motion-brief-support-reconsideration-9-23-2019-dckt-33-0.pdf">Government Motion/Brief in Support of Reconsideration</a> (September 23, 2019) <a href="/system/files/media/file/2019/09/government-proposed-motion-for-court-site-neutral-9-23-2019-dckt-33-1.pdf">Government Proposed Order for the Court</a> (September 23, 2019) <a href="/system/files/media/file/2019/09/Site-Neutral-Payment-Policy-Opinion_20190717.pdf">Opinion in the AHA's Case on OPPS Site Neutral Payment Policy</a> (September 17, 2019) <a href="/system/files/media/file/2019/08/aha-aamc-hospitals-response-to-judge-show-cause-order-on-consolidation-8-20-2019.pdf">AHA, AAMC and Hospitals Response to Judge Show Cause Order On Consolidation</a> (August 20, 2019) <a href="/system/files/media/file/2019/08/order-to-show-cause-8-15-2019-site-neutral.pdf">Order to Show Cause</a> (August 15, 2019) <a href="/system/files/media/file/2019/08/aha-hospital-organizations-notice-request-for-status-conference-8-2-2019.pdf">AHA and hospital organizations notice and request for a status conference</a> (August 8, 2019) <a href="/system/files/media/file/2019/04/government-reply-in-support-of-its-motion-april-19-2019-site-neutral_0.pdf">Government's reply in support of its motion</a> (April 19, 2019) <a href="/system/files/media/file/2019/04/AHA-REPLY-to-government-motion-to-dismiss_20190405.pdf">Reply in Support of Plaintiffs’ Motion for Summary Judgment and Memorandum in Opposition to Defendant’s Cross-Motion to Dismiss or for Summary Judgment</a> (April 5, 2019) <a href="/system/files/media/file/2019/03/Site-neutral-defendant-opposition-to-summary-judgment-filed-032219.pdf">Defendant's Opposition to Plaintiff's Motion for Summary Judgment and Memorandum in Support of Motion to Dismiss</a>&nbsp;(March 22, 2019) <a href="/system/files/2019-03/Minute-order-of-Judge-Collyer-establishing-new-consolidated-briefing-schedule-in-site-neutral-lawsuit_20190309.pdf">Minute order of Judge Collyer establishing new consolidated briefing schedule in site neutral lawsuit</a> (March 9, 2019) <a href="/system/files/2019-03/Response-to-the-Courts-Minute-Order-of-February-27-2019_20190306.pdf">Response to the Court’s Minute Order of February 27, 2019</a> (March 6, 2019) <a href="/system/files/2019-02/Courts-minute-order-setting-case-briefing-schedule_digital_20190204.pdf">Court’s minute order setting case briefing schedule</a> (February 4, 2019) <a href="/system/files/2019-02/Plaintiffs-Motion-for-Summary-Judgment-Site-Neutral-Payment-Policy_2019-02-01.pdf">Plaintiffs’ Motion/Brief for Summary Judgment</a> (February 1, 2019) <ul> <li><a href="/system/files/2019-02/Plaintiffs-Declarations-Site-Neutral-Payment-Policy_2019-02-01.pdf">Plaintiffs’ Declarations</a> (February 1, 2019)</li> <li><a href="/system/files/2019-02/Plaintiffs-Declarations-and-Proposed-Order-Site-Neutral-Payment-Policy_2019-02-01.pdf">Plaintiffs’ Declarations and Proposed Order</a> (February 1, 2019)</li> </ul> <a href="/system/files/2019-02/Joint-Motion-for-Briefing-Schedule-Site-Neutral-Payment-Policy_2019-02-01.pdf">Joint Motion for Briefing Schedule</a> (February 1, 2019) <ul> <li><a href="/system/files/2019-02/Joint-Proposed-Order-for-Briefing-Schedule-Site-Neutral-Payment-Policy_2019-02-01.pdf">Joint Proposed Order for Briefing Schedule</a> (February 1, 2019)</li> </ul> <a href="/system/files/2019-01/aha-site-neutral-amended-complaint-1-29-2019_0.pdf">Amended Complaint</a> (January 29, 2019) <a href="/system/files/2018-12/complaint-challenging-site-neutral-payment-policy181204.pdf">Complaint Challenging Site Neutral Payment Policy</a> (December 4, 2018) </div> </li> <li class="a-items"> 340B Payment Reductions <div class="a-content"> <a href="/legal-documents/2022-09-28-judge-orders-hhs-immediately-halt-unlawful-reimbursement-cuts-remainder" target="_blank">Judge Orders HHS to Immediately Halt Unlawful Reimbursement Cuts for Remainder of 2022 </a> (September 28, 2022) <a href="/2022-09-21-amicus-brief-reply-support-plaintiffs-motion-hold-unlawful-and-remedy-defendants-past" target="_blank">Reply in Support of Plaintiffs’ Motion to Hold Unlawful and Remedy Defendants’ Past Underpayment of 340b Drugs</a> (September 21, 2022) <a href="/legal-documents/2022-08-17-ahas-reply-support-plaintiffs-motion-vacate-unlawful-portion-2022-opps" target="_blank">Reply in Support of Plaintiffs’ Motion to Vacate the Unlawful Portion of the 2022 OPPS Rule</a> (August 17, 2022) <a href="/system/files/media/file/2022/08/unopposed-motion-for-permission-to-file-second-supplemantal-complaint-re-340B-payment-reduction-8-3-22.pdf" target="_blank">Unopposed Motion For Permission To File Second Supplemantal Complaint</a> (August 3, 2022) <a href="/system/files/media/file/2022/08/second-supplemental-complaint-re-340b-payment-reduction-8-3-22.pdf" target="_blank">Second Supplemental Complaint</a> (August 3, 2022) <a href="/system/files/media/file/2022/08/motion-to-vacate-the-unlawful-portion-of-the-2022-opps-rule-re-340b-payment-reduction-8-3-22.pdf">Motion to Vacate The Unlawful Portion of the 2022 OPPS Rule</a> (August 3, 2022) <a href="/system/files/media/file/2022/08/motion-to-hold-unlawful-and-remedy-defendants-past-underpayment-of-340b-drugs-8-3-22.pdf" target="_blank">Motion to Hold Unlawful And Remedy Defendants’ Past Underpayment Of 340b Drugs</a> (August 3, 2022) <a href="https://www.supremecourt.gov/opinions/21pdf/20-1114_09m1.pdf" target="_blank">Supreme Court Rules Unanimously in Favor of AHA, Others in 340B Case</a> (June 15, 2022) <a href="/news/blog/2021-11-29-live-analysis-supreme-court-hears-oral-arguments-ahas-340b-case" target="_blank">Live Analysis: Supreme Court Hears Oral Arguments in AHA’s 340B Case</a> (November 30, 2021) <a href="/legal-documents/2021-11-20-aha-associations-hospitals-respond-government-340b-supreme-court-case" target="_blank">AHA, Associations, Hospitals Respond to Government in 340B Supreme Court Case</a> (November 19, 2021) <a href="/legal-documents/2021-10-21-government-responds-hospital-340b-payment-reduction-challenge-oct-20">Government Responds to Hospital 340B Payment Reduction Challenge</a> (October 20, 2021) <a href="/amicus-brief/2021-09-13-amicus-brief-academic-medical-centers-support-aha-340b-case-september-10">Amicus Brief: Academic Medical Centers Support AHA in 340B Case</a> (September 10, 2021) <a href="/amicus-brief/2021-09-13-amicus-brief-state-and-regional-hospital-associations-express-support-ahas">Amicus Brief: State and Regional Hospital Associations Express Support for AHA’s 340B Case</a> (September 9, 2021) <a href="/legal-documents/2021-09-03-aha-opening-brief-case-urging-us-supreme-court-reverse-cut-340b-program">AHA Opening Brief in Case Urging U.S. Supreme Court to Reverse Cut to 340B Program</a> (September 3, 2021) <a href="/legal-documents/2021-05-28-aha-reply-government-related-petition-cert-us-supreme-court-re-340b">AHA Reply to Government Related to Petition for Cert At US Supreme Court</a> (May 28, 2021) <a href="/2021-03-15-amicus-brief-hospital-systems-340b-payment-reductions-march-12-2021">Amicus Brief–Hospital Systems </a> (March 12, 2021) <a href="/amicus-brief/2021-02-23-amicus-brief-state-and-regional-hosp-associations-340b-case">Amicus Brief-State and Regional Hospital Associations</a> (Feb. 23, 2021) <a href="/legal-documents/2021-02-10-aha-asks-us-supreme-court-hear-case-340b-payment-cuts">AHA Asks U.S. Supreme Court to Hear Case on 340B Payment Cuts</a> (Feb. 10, 2020) <a href="/legal-documents/2020-09-14-hospital-groups-petition-rehearing-re-340-b-payment-reductions-sept-14">Hospital Groups Petition for Rehearing</a> (Sept. 14, 2020) <a href="/legal-documents/2020-07-31-appeals-court-decision-july-31-2020-re-340b-payment-reductions-cy-2018">Appeals Court Decision</a> (July 31, 2020) <a href="/system/files/media/file/2019/11/aha-associations-hospitals-response-government-letter-to-dc-circuit-court-re-nov-8-oral-argument-%20340b-payment-reductions-11-14-19.pdf">AHA, Associations, Hospitals response the Government’s Letter to the D.C. Circuit Following Oral Argument in Appeal of The District Court’s Judgment</a> (November 14, 2019) <a href="/legal-documents/2019-11-14-government-letter-following-oral-argument-appeal-district-courts">Government’s Letter to the D.C. Circuit Following Oral Argument in Appeal of the District Court’s Judgment in Favor AHA, Associations, and Hospitals</a> (November 12, 2019) <a href="/system/files/media/file/2019/10/appellants-reply-brief-340b-10-11-2019.pdf">Government's Reply Brief in Its Appeal</a>&nbsp;(October 11, 2019) <a href="/system/files/media/file/2019/09/aha-associations-hospitals-reply-brief-in-government-appeal-340b-9-24-2019.pdf">AHA, Associations, Hospitals Reply Brief in Government Appeal 340B</a> (September 24, 2019) <a href="/system/files/media/file/2019/09/amicus-brief-filed-by-the-federation-of-american-hospitals-9-10-2019.pdf">Amicus Brief Filed by the Federation of ��s (FAH)</a> (September 10, 2019) <a href="/system/files/media/file/2019/09/governments-initial-brief-in-appeal-of-judgement-in-favor-of-aha-associations-hospitals.pdf">Government’s Initial Brief in Their Appeal of the Judgement In Favor of the AHA, Associations and Hospitals</a> (Sept. 3, 2019) <a href="/system/files/media/file/2019/07/order-grants-consolidation-of-cases-to-expedite-340b-doc-1799771-7-30-2019.pdf">Court Grants the Motion to Expedite the Appeal in 340B</a> (July 30, 2019) <a href="/system/files/media/file/2019/07/azar-vs-aha-appellees-consent-motion-to-expedite-7-24-2019.pdf">Appellees’ Consent Motion to Expedite Briefing</a> (July 24, 2019) <a href="/system/files/media/file/2019/07/2019-07-10-Memorandum-Opinion-340B.pdf">Memorandum Opinion Granting Defendants' Motion for Entry of Final Judgement</a>, (July 10, 2019) <ul> <li><a href="/system/files/media/file/2019/07/2019-07-10-Order-Granting-Motion-for-Entry-of-Final-Judgement-Denying-as-Moot.pdf">Order Granting Defendants' Motion for Entry of Final Judgment,</a> (July 10, 2019)</li> </ul> <a href="/system/files/media/file/2019/06/2019-06-10-ecf-57-defendants-reply-in-support-of-motion-for-reconsider.pdf">Defendant's reply in Support of Motion for Reconsideration and Entry of Final Judgmen</a>t&nbsp;(June 10, 2019) <a href="/system/files/media/file/2019/06/2019-06-07-ecf-056-plaintiffs-response-to-defendants-motion-for-reconsideration-340B-payment-reduction.pdf">Plaintiffs’ Response to Defendants’ Motion for Reconsideration, Entry of Final Judgment, and Expedited Briefing</a> (June 7, 2019) <a href="/system/files/media/file/2019/06/plaintiffs-reply-in-support-of-motion-for-a-firm-date.pdf">Plaintiffs’ Reply In Support of Motion for a Firm Date</a> (June 4, 2019) <a href="/system/files/media/file/2019/06/2019-05-31-efc-053-defendants-opposition-to-plaintiffs-motion-for-firm-date.pdf">Government’s Reply to Plaintiff's Motion to Expedite a Remedy</a> (May 31, 2019) <a href="/system/files/media/file/2019/05/2019-05-10-ECF-051-defendants_motion-firm-date-by-which-defendants-must-propose-remedy-for-violations-medicare-act.pdf">Plaintiffs’ Motion for a Firm Date by Which Defendants Must Propose a Remedy for Violations of the Medicare Act</a> (May 10, 2019) <ul> <li><a href="/system/files/media/file/2019/05/2019-05-10-ECF-051-01-text-proposed-order.pdf">Proposed Order</a> (May 10, 2019)</li> </ul> <a href="/system/files/media/file/2019/05/2019-05-06-ECF-050-memorandum-opinion-granting-part-motion-permanent-injunction-remanding-2018-2019-opps-rules-to-hhs.pdf">Memorandum Opinion Granting in Part Plaintiffs’ Motion for a Permanent Injunction; Remanding the 2018 and 2019 OPPS Rules to HHS</a> (May 6, 2019) <a href="/system/files/2019-02/2019-02-26_Reply-ISO-Mot-for-Perm-Inj-and-Oppn-to-MTD_as-filed.pdf">Opposition to Government’s Motion to Dismiss and Reply in Support of Motion for a Permanent Injunction Covering the 2019 OPPS Rule</a> (February 26, 2019) <a href="/system/files/2019-02/2019-02-22_ECF-043_Memorandum-in-Support-of-Motion-to-Dismiss-New-Claim-and-Opposition-to-Motion-for-PI-with-Respect-to-2019-OPPS-Rule.PDF">Memorandum in Support of Motion to Dismiss New Claim and Opposition to Motion for Permanent Injunctions with Respect to 2019 OPPS Rule</a> (February 22, 2019) <a href="/system/files/2019-02/2019-02-11_ECF-035_Plaintiffs_Motion-for-a-Permanent-Injunction-Cover-2019-OPPS-Rule.pdf">AHA, Associations, Hospitals’ motion for an injunction for 2019</a> (February 11, 2019) <a href="/system/files/2019-02/ECF-37--Plaintiffs-Response-Brief-on-Remedies.pdf">AHA, Associations, Hospitals Remedies Reply Brief</a> (February 14, 2019) <a href="/system/files/2019-02/2019-02-14_ECF-036_Defendants-Opposition-on-Remedy.PDF">Government’s Remedies Reply Brief</a>&nbsp;(February 14, 2019) <a href="/system/files/2019-02/2019-02-07_ECF-034_Plaintiffs_Motion-for-Leave-to-File-Supplemental-Complaint.PDF">AHA, Associations, Hospitals Motion for Leave to File Supplemental Complaint</a> (February 7, 2019) <ul> <li><a href="/system/files/2019-02/2019-02-07_ECF-034-03_Ex-C--Proposed-Supplemental-Complaint.PDF">Proposed Supplemental Complaint</a> (February 7, 2019)</li> <li><a href="/system/files/2019-02/2019-02-07_ECF-034-04_Ex-D--Redline-with-Original-Complaint.PDF">Redline of Proposed Supplemental Complaint</a> (February 7, 2019)</li> <li><a href="/system/files/2019-02/2019-02-07_ECF-034-05_Text_Proposed-Order.PDF">Proposed Order to Grant Motion</a> (February 7, 2019)</li> </ul> <a href="/system/files/2019-02/2019-02-07_ECF-033_FAH_s-Motion-for-Leave-to-File-Amicus-Brief.PDF">Federation of ��s’ Motion for Leave to file Amicus in support of neither party</a> (February 7, 2019) <ul> <li><a href="/system/files/2019-02/2019-02-07_ECF-033-01_Ex-A--FAH-Amicus-Brief.PDF">FAH Proposed Amicus Brief</a> (February 7, 2019)</li> </ul> <a href="/system/files/2019-02/2019-01-31-Plaintiffs-Brief-on-Remedies-as-filed.pdf">AHA, Associations, Hospitals Remedies Brief</a> (January 31, 2019) <a href="/system/files/2019-02/2019-01-31-ECF-031-Defendant_s-Brief-on-Remedy.PDF">Govt. Remedies Brief</a> (January 31, 2019) <ul> <li><a href="/system/files/2019-02/2019-01-31-ECF-031-01-Declaration-of-Elizabeth-Richter.PDF">Declaration of CMS’s Elizabeth Richter</a> (January 31, 2019)</li> </ul> <a href="/system/files/2019-01/2019-01-07-ECF-027-Plaintiffs-Opposition-to-Motion-to-Stay.pdf">AHA, Associations, Hospitals Opposition to Request to Stay Proceedings</a> (January. 7, 2019) <ul> <li> <ul> <li><a href="/system/files/2019-02/Joint-Proposed-Order-for-Briefing-Schedule-Site-Neutral-Payment-Policy_2019-02-01.pdf">Joint Proposed Order for Briefing Schedule</a> (February 1, 2019)</li> </ul> <ul> </ul> <ul> <li><a href="/system/files/2018-12/0029-2018-12-20-notice-of-Filing-amended-complaint.pdf">Notice of amending complaint filing</a> (December. 20, 2018)</li> </ul> <ul> <li><a href="/system/files/2018-11/181121-340b-delay-proposed-order.pdf">Proposed Order</a></li> <li><a href="/system/files/2018-11/181121-340b-delay-exhibits.pdf">Exhibits</a></li> </ul> <ul> <li><a href="/system/files/2018-10/181015-proposed-order-motion-to-stay-340b.pdf">Proposed Order</a></li> </ul> <ul> <li><a href="/system/files/2018-09/180911-340b-delay-suit-complaint.pdf">Complaint</a></li> <li><a href="/system/files/2018-09/180911-plaintiffs-motion-for-summary-judgement.pdf">Motion for Summary Judgment</a></li> <li><a href="/system/files/2018-09/180911-memo-points-authorities-plaintiffs-motion.pdf">Memorandum in Support of Motion</a></li> </ul> <ul> <li><a href="/system/files/2019-01/2019-01-07-ECF-027-02-Ex-B-Order-in-Maryland-v-US-1-03-2019.pdf">Order in Maryland v. US</a></li> <li><a href="/system/files/2019-01/2019-01-09-ECF-028-Plaintiffs-Notice-of-Supplemental-Authority.pdf">Plaintiffs’ Notice of Supplemental Authority</a> (January&nbsp;9, 2019)</li> <li><a href="/system/files/2019-01/2019-01-09-ECF-028-01-USCA-Order-of-01-09-2018.pdf">Supplemental Authority Cited - Court of Appeals Jan. 9 Order denying Stay on basis of Appropriations Lapse</a></li> </ul> </li> <li><a href="/system/files/2019-01/2019-01-06-ECF-026-Defendants-Motion-for-Stay-in-Light-of-Lapse-in-Appropriations.pdf">Govt. Motion to Stay Case Proceedings in Light of Appropriations Lapse</a> (January 6, 2019) <div class="body"> <a href="/system/files/2018-12/Opinion%20%20on%20340B%20Injunction%2012.27.18.pdf">Court opinion</a> (December 27, 2018) <ul> <li><a href="/system/files/2018-12/Order-on-340B-Injunction-12-27-18.pdf">Associated order of the Court</a> (December 27, 2018)</li> </ul> <a href="/system/files/2018-12/181203-notice-of-alj-rulings.pdf">Notice of ALJ Rulings</a> (December 3, 2018) <a href="/system/files/2018-10/181010-govt-reply-340b.pdf">Government's reply brief in support of their motion to dismiss</a> (October 10, 2018) <a href="/system/files/2018-10/180926-reply-motion-for-permanent-injunction.pdf">Plaintiffs' reply brief in in support of motion for preliminary and permanent injunction and opposition to government’s motion to dismiss</a> (September 26, 2018) <a href="/system/files/2018-09/180914-340b-govt-motion-to-dismiss.pdf">Government's Motion to Dismiss</a> (September 14, 2018) <ul> <li><a href="/system/files/2018-09/180914-340b-govt-memo-in-support-motion-dismiss.pdf">Memorandum in Support of Defendants' Motion to Dismiss</a></li> <li><a href="/system/files/2018-09/180914-340b-proposed-order.pdf">Proposed Order</a></li> <li><a href="/system/files/2018-09/180914-340b-exhibit1-2016-cms-stats.pdf">Exhibit 1: 2016 CMS Statistics</a></li> <li><a href="/system/files/2018-09/180914-340b-exhibit2-htc-manual.pdf">Exhibit 2: Hemophilia Treatment Center Manual </a></li> </ul> <a href="/legal-documents/2018-09-05-hospital-groups-refile-lawsuit-reverse-cuts-340b-hospitals">Hospital Groups Refile Lawsuit to Reverse Cuts for 340B Hospitals</a> (September 5, 2018) <ul> <li><a href="/system/files/2018-09/180905-complaint-340b-refiling-suit.pdf">Complaint</a></li> <li><a href="/system/files/2018-09/180905-brief-340b-refiling-suit.pdf">Brief</a></li> </ul> <a href="/system/files/2018-07/180717-340b-suit-dismissal.pdf">Appeals court dismisses 340B payment lawsuit for lack of presentment</a> (July 17, 2018) <a href="/legal-documents/2018-06-14-letter-us-court-appeals-dc-circuit-providing-mac-notices-exhibits-re">Letter to Court of Appeals for the D.C. Circuit providing MAC notices</a> (June 14, 2018) <a href="/system/files/2018-05/20180510-letter-hhs-28j.pdf">Government's 28(j) Letter</a> (May 10, 2018) <ul> <li><a href="/system/files/2018-05/20180511-letter-responding-to-28j.pdf">AHA Response to the Government's 28(j) Letter</a> (May 11, 2018)</li> </ul> </div> <a href="/2018-04-02-aha-reply-brief-340b-appeal">AHA Reply Brief Calls for Preliminary Injunction</a> (April 2, 2018) <a href="/legal-documents/2018-03-20-governments-brief-march-19-2018">Government's Brief</a> (March 19, 2018) <a href="/amicus-brief/2018-02-22-aha-hospital-associations-amicus-brief-340b-appeal-feb-22-2018">Hospital Associations Amicus Brief in 340B Appeal</a> (February 22, 2018) <a href="/legal-documents/2018-02-15-ahas-appeal-brief-re-340b-payment-reductions-included-opps-rule ">AHA's Appeal Brief re 340B Payment Reductions</a> (February 15, 2018) <a href="/system/files/2018-02/180130-courts-grants-expedite-340b.pdf">340B Appeal: Court grants Associations, Hospitals Motion to Expedite</a> (January 30, 2018) <a href="/system/files/2018-02/180122-reply-in-support-motion-expedite-340b.pdf">340B Motion to Expedite: Associations, Hospitals Reply</a> (January 22, 2018) <a href="/system/files/2018-02/180119-motion-to-expedite-340b.pdf">340B Motion to Expedite: HHS Response</a> (January 19, 2018) <a href="/system/files/2018-02/180117-motion-to-expedite-340b.pdf">340B Litigation – Associations, Hospitals Motion to Expedite Appeal </a>(January 17, 2018) <a href="/legal-documents/2018-01-09-aha-aamc-aeh-hospitals-notice-appeal">AHA, AAMC, AEH, Hospitals, Notice of Appeal</a> (January 9, 2018) Court Decision in 340b Case (December 29, 2017) <ul> <li><a href="/legal-documents/2017-12-29-aha-v-eric-d-hargan-order-granting-motion-dismiss" target="_blank">Court Order Granting Govt. Motion to Dismiss</a></li> <li><a href="/system/files/content/17/171229-ecf-024-memorandum-opinion-garnting-motion-to-dismiss-denying-as-moot-motion-for-preliminary-injunction.pdf" target="_blank">Court Memorandum Opinion Granting Govt. Motion to Dismiss</a></li> </ul> <a href="/system/files/content/17/171215-340b-payment-reductions-in-2018-final-opps-rule.pdf" target="_blank">Government’s reply brief</a> (December 15, 2017) <a href="/system/files/content/17/171208-amicus-brief-associations-340b.pdf">Hospital Associations Amicus Brief Supporting 340B lawsuit</a> (December 8, 2017) <a href="/system/files/content/17/171208-ahareplyisomotionforpreliminjunction.pdf">AHA, AAMC, AEH, Hospitals reply to Govt's Motion to Dismiss 340B lawsuit</a> (December 8, 2017) <a href="/system/files/content/17/171201-govt-brief-motion-to-dismiss.pdf">Department of Health and Human Services' Motion to Dismiss</a> (December 1, 2017) <ul> <li><a href="/system/files/content/17/171201-memo-support-motion-to-dismiss.pdf">Memorandum in Support of Government Motion to Dismiss and in Opposition to Plaintiffs' Motion for Preliminary Injunction</a></li> </ul> <a href="/system/files/content/17/171113-complaint-340b-final-opps-rule.pdf">Complaint: AHA, Hospital groups v. Department of Health and Human Services</a> (November 13, 2017) <a name="appeals"></a> <ul> <li><a href="/system/files/content/17/171113-motion-for-pi-340b.pdf">Motion for Preliminary Injunction</a></li> <li><a href="/system/files/content/17/171113-motion-iso-pi-340b.pdf">Memo in Support of Motion for Preliminary Injunction (with attachments)</a></li> </ul> </li> </ul> </div> </li> <li class="a-items"> AHA, Hospitals Sue to Require HHS to Meet Deadlines for Deciding Appeals <div class="a-content"> <a href="/legal-documents/2023-04-10-alj-delay-april-2023-status-report-filed-april-7-2023">ALJ Delay April 2023 Filing </a>, April 7, 2023 <a href="/amicus-brief/2022-09-23-plaintiffs-opposition-defendants-motion-modify-courts-mandamus-order-re">Plaintiffs’ Opposition to Defendant’s Motion to Modify This Court’s Mandamus Order Re Medicare Appeals</a>, September 23, 2022 <a href="/legal-documents/2022-03-30-aha-v-becerra-march-2022-status-report">AHA v Becerra Medicare Appeals Status Report and Dashboard</a>, March 30, 2022 <a href="/legal-documents/2021-09-28-alj-delay-case-status-report-and-dashboard-sept-28-2021">ALJ Delay Status Report and Dashboard</a>, September 28, 2021 <a href="/2021-06-25-alj-delay-case-status-report-and-dashboard-june-25-2021">ALJ Delay Status Report and Dashboard</a>, June 25, 2021 <a href="/legal-documents/2021-03-26-alj-delay-status-report-and-dashboard-re-aha-hospitals-sue-require-hhs">ALJ Delay Status Report and Dashboard</a>, March 26, 2021 <a href="/legal-documents/2020-09-24-alj-delay-status-report-and-dashboard-re-aha-hospitals-sue-require-hhs">ALJ Delay Status Report and Dashboard</a>, September 24, 20200 <a href="/legal-documents/2020-06-26-alj-delay-status-report-june-26-2020">ALJ Delay Status Report and Dashboard</a>, June 26, 2020 <a href="/legal-documents/2020-03-28-hhss-march-25-2020-status-report-and-medicare-appeals-dash-board-march">HHS’s March 25 Status Report and Medicare Appeals Dash Board</a> (March 25, 2020) <a href="/legal-documents/2019-12-31-hhss-december-31-status-report-and-medicare-appeals-dashboard-december">HHS's December 31 Status Report and Medicare Appeals DashBoard</a>&nbsp;(December 31, 2019) <a href="/system/files/media/file/2019/09/aha-v-price-september-medicare-appeals-dashboard-9-27-2019.pdf">Medicare Appeals Dashboard</a>&nbsp;(September 27, 2019) <a href="/system/files/media/file/2019/09/aha-v-price-september-status-report.pdf">Status Report</a>&nbsp;(September 27, 2019) <a href="/system/files/media/file/2019/07/aha-vs-azar-july-status-report.pdf">HHS July Status Report</a> (July 1, 2019) <ul> <li><a href="/system/files/media/file/2019/07/aha-vs-azar-july-status-report-dashboard.pdf">HHS July Status Report Dashboard</a></li> </ul> <a href="/news/headline/2018-11-01-court-rules-aha-medicare-appeals-backlog-case">Court rules for AHA in Medicare appeals backlog case</a> (Nov. 1, 2018) <ul> <li><a href="/system/files/2018-11/181101-aljdelay-remedyopinion.pdf">Remedial Opinion</a></li> <li><a href="/system/files/2018-11/181101-aljdelay-remedyorder.pdf">Remedy Order</a></li> </ul> <a href="/system/files/2018-08/AHA-v-Azar-Plaintiffs-Remedies-Reply-With-ECF-Stamp.pdf">AHA, Hospitals reply to Government’s response to recommended non-deadline remedies</a> (Aug. 10, 2018) <a href="/legal-documents/2018-08-06-secretarys-remedy-response-brief">Government's Response to the Remedies Response</a> (Aug. 3, 2018) <ul> <li><a href="/system/files/2018-08/180803-ahavazar-secy-remedy-brief.pdf">Secretary's Remedy Brief</a></li> <li><a href="/system/files/2018-08/180803-ahavazar-griswold-remedy-declaration.pdf">Griswold Remedy Declaration</a> <ul> <li><a href="/system/files/2018-08/180803-ahavazar-griswold-remedy-declaration-exh-a.pdf">Griswold Remedy Declaration Exhibit A</a></li> <li><a href="/system/files/2018-08/180803-ahavazar-griswold-remedy-declaration-exh-b.pdf">Griswold Remedy Declaration Exhibit B</a></li> </ul> </li> <li><a href="/system/files/2018-08/180803-ahavazar-mills-remedy-declaration.pdf">Mills Remedy Declaration</a></li> <li><a href="/system/files/2018-08/180803-ahavazar-mcqueen-remedy-declaration.pdf">McQueen Remedy Declaration</a></li> <li><a href="/system/files/2018-08/180803-ahavazar-cochran-remedy-declaration.pdf">Cochran Remedy Declaration</a></li> <li><a href="/system/files/2018-08/180803-ahavazar-iwugo-remedy-declaration.pdf">Iwugo Remedy Declaration</a></li> </ul> <a href="/system/files/2018-07/180719-alj-delay-courts-grants-ext.pdf">The Court grants govt until Aug 3 to respond to AHA, Hospitals remedies brief</a> (July 19, 2018) <a href="/system/files/2018-07/180711-notice-electronic-filing-extension-request.pdf">Government does not get anywhere as much time for its reply as they requested</a> (July 11, 2018)&nbsp; <a href="/system/files/2018-07/180702-hospitals-oppose-sec-motion-for-extension.pdf">AHA, Hospitals Oppose the Secretary Motion for Extension of Time to Reply</a> (July 5, 2018) <ul> <li><a href="/system/files/2018-07/180702-govt-extension-motion.pdf">Government's motion for extension</a></li> </ul> <a href="/system/files/2018-06/180622-aha-azar-plaintiff-opening-brief.pdf">AHA, Hospitals brief outlining non-deadline remedies to address appeals backlog</a> (June 22, 2018) <ul> <li><a href="/system/files/2018-06/180622-aha-azar-plaintiffs-remedy-proposed-order.pdf">Proposed Remedial Order</a></li> </ul> <a href="/legal-documents/2018-03-22-court-order-alj-delay-case-march-22-2018">Court Order</a> (March 22, 2018) <a href="/system/files/media/file/2019/08/aha-v-azar-340b-response-to-plaintiffs-notice-of-supplemental-authority-3-21-18.pdf">Response to Plaintiffs Notice of Supplemental Authority</a> (March 21, 2018) <a href="/system/files/media/file/2019/08/aha-v-azar-declaration-michael-r-bagel-3-21-2018.pdf">Declaration of Michael R. Bagel</a> (March 21, 2018) <a href="/system/files/2018-03/180227-court-date-alj-delay.pdf">Court Sets Hearing Date for ALJ Delay Mandamus Remand</a> (February 27, 2018) <a href="/legal-documents/2018-02-15-reply-brief-aha-hospitals-alj-backlog-mandamus-order">AHA's and Hospitals' Reply Brief: Reinstate HHS Deadline to Clear Appeals Backlog</a> (February 15, 2018) <a href="/system/files/2018-02/AHAvAzar-SecyOpptoMSJ.pdf">Government’s Brief in Support of its Motion for Summary Judgment/in Opposition to AHA, Hospitals’ Motion for Summary Judgment</a> (February 1, 2018) <ul> <li><a href="/system/files/2018-02/AHAvAzar-GriswoldSuppDecl.pdf">Nancy Griswold's Supporting Declaration</a></li> <li><a href="/system/files/2018-02/AHAvAzar-SecyUpdatedWorkloadProjections.pdf">Medicare Appeals Updated Workload Projections</a></li> </ul> <a href="/system/files/content/17/aha-vs-hargan.pdf" target="_blank">AHA's and Hospitals' Reply Brief on Mandamus Remand</a> (December 20, 2017) <a href="/system/files/2018-02/171122-AHAvHargan-MillsProgramIntegrityDeclaration.pdf">Declaration of George Mills, Deputy Director of the Center for Program Integrity (CPI), CMS</a> (November 22, 2017) <a href="/system/files/2018-02/171103-AHAvHargan-MSJ.pdf">Government's Motion for Summary Judgment in the ALJ Mandamus Remand</a> (November 3, 2017) <ul> <li><a href="/system/files/2018-02/171103-AHAvHargan-MSJBagelDecl.pdf">Declaration of Michael R. Bagel</a></li> <li><a href="/system/files/2018-02/171103-AHAvHargan-MSJGriswoldDecl.pdf">Declaration of Nancy J. Griswold</a></li> <li><a href="/system/files/2018-02/171103-AHAvHargan-MSJMcQueenDecl.pdf">Declaration of Sherri McQueen</a></li> <li><a href="/system/files/2018-02/171103-AHAvHargan-MSJMillsDecl.pdf">Declaration of George G. Mills</a></li> <li><a href="/system/files/2018-02/171103-AHAvHargan-MSJMemoofLaw.pdf">Memorandum of Points and Authorities in Support of Defendant's Motion for Summary Judgment</a></li> <li><a href="/system/files/2018-02/171103-AHAvHargan-MSJStatementofFacts.pdf">Defendant's Statement of Facts</a></li> </ul> <a href="/system/files/2018-03/171025-extension-granted.pdf">Court Grants In Part Govt’s Request for Additional Time</a> (October 25, 2017) <a href="/system/files/2018-02/171023-AHAvHargan-PartialExtOpp.pdf">AHA, Hospitals Oppose Request of Govt. for Additional Time to File</a> (October 23, 2017) <a href="/system/files/2018-02/AHAvPrice-HHSExtensionMotion.pdf">Government Requests Extension of Time to File Its Motion for Summary Judgment </a>(October 19, 2017) <a href="/system/files/2018-02/170928-AHAvPrice-OrderGoverningFurtherProceedings.pdf">Trial Court Sets Briefing Schedule in ALJ Mandamus Remand</a> (September 28, 2017) <a href="/system/files/2018-03/170914-court-order-granting-motion-for-immediate-issuance.pdf">Appeals Court grants AHA, Hospitals Request for Immediate Issuance of Mandate of Remand</a> (September 14, 2017) <ul> <li><a href="/system/files/2018-03/170914-issuance-of-mandate-immediate-remand-to-trial-court.pdf">Issuance of the Mandate of Immediate Remand to the Trial Court</a></li> </ul> <a href="/system/files/2018-02/AHAvPrice-MandateMotion.pdf">AHA, Hospitals Unopposed Motion to Issue Mandate for Case Remand Without Delay</a> (September 11, 2017) <a href="/legal/litigation-aha-hospitals-sue-require-hhs-meet-deadlines-deciding-appeals">Read more on this topic</a> </div> </li> </ul> </li> </ul> </li> </ul> </div> &nbsp; <ul class="a-container"> <ul class="a-container"> item 1 <div class="a-content"> ==== </div> </li> </ul> <div> --&gt; function openCity(evt, cityName) { var i, tabcontent, tablinks; tabcontent = document.getElementsByClassName("tabcontent"); for (i = 0; i &lt; tabcontent.length; i++) { tabcontent[i].style.display = "none"; } tablinks = document.getElementsByClassName("tablinks"); for (i = 0; i &lt; tablinks.length; i++) { tablinks[i].className = tablinks[i].className.replace(" active", ""); } document.getElementById(cityName).style.display = "block"; evt.currentTarget.className += " active"; } // Get the element with id="defaultOpen" and click on it document.getElementById("defaultOpen").click(); </ul> </div> <table border="0" cellpadding="6" class="table" width="80%"> <tbody> <tr> <td align="center" valign="top"> <a class="btn btn-primary btn-wide" href="/legal/past-litigation">PAST LITIGATION</a> </td> <td align="center" valign="top"> <a class="btn btn-primary btn-wide" href="/amicus-briefs">AMICUS BRIEFS</a> </td> </tr> </tbody> </table> </div> /* reset */ .cc_tabs ul.a-container { margin: 0; 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Below are our most recent friend-of-the-court briefs. <a href="/amicus-brief/2022-08-15-amicus-brief-aha-aamc-support-united-states-motion-preliminary-injunction" target="_blank">Amicus Brief: AHA AAMC in Support of the United States’ Motion for Preliminary Injunction Re: US v the State of Idaho</a>, August 16, 2022 <a href="/amicus-brief/2022-06-29-amicus-brief-hospital-groups-urge-appeals-court-uphold-340b-requirements" target="_blank">Amicus Brief: Hospital Groups Urge Appeals Court to Uphold 340B Requirements In Contract Pharmacy Case</a>, June 29, 2022 <a href="/amicus-brief/2022-06-08-amicus-brief-6th-circuit-case-prep-act-immunity" target="_blank">Amicus Brief in 6th Circuit Case on PREP Act Immunity </a>, June 8, 2022 <a href="/amicus-brief/2022-05-20-amicus-brief-aha-us-chamber-commerce-and-amc-re-hospital-retirement-plan" target="_blank">Amicus Brief: AHA, US Chamber of Commerce and AMC Re: Hospital Retirement Plan Case</a>, May 22, 2022 <a href="/amicus-brief/2022-05-17-novartis-united-therapeutics-corp-v-johnson-re-340b" target="_blank">Amicus Brief: AHA, Hospital Groups Urge Appeals Courts to Uphold 340B Requirements Re: Novartis-United Therapeutics Corp. v. Johnson</a>, May 17, 2022 <a href="/amicus-brief/2022-05-17-sanofi-aventis-us-v-hhs-et-al-re-340b" target="_blank">Amicus Brief: AHA, Hospital Groups Urge Appeals Courts to Uphold 340B Requirements Re: Sanofi-Aventis U.S. v. HHS et al</a>, May 17, 2022 <a href="/amicus-brief/2022-05-16-amicus-brief-aha-urges-supreme-court-reverse-9th-circuit-decision-re-axon" target="_blank">Amicus Brief: AHA Urges Supreme Court to Reverse 9th Circuit Decision Re: Axon Enterprise Inc. v. FTC, et al</a>, May 16, 2022 <a href="/amicus-brief/2022-05-13-amicus-brief-aha-other-hospital-and-health-care-organizations-re-wit-v" target="_blank">Amicus Brief: AHA, Other Hospital and Health Care Organizations Re: Wit v. United Behavioral Health</a>, May 13, 2022 <a href="/amicus-brief/2022-04-29-amicus-brief-aha-others-yale-new-haven-erisa-retirement-plan-management">Amicus Brief of AHA, Others in Yale New Haven ERISA Retirement Plan Management Case in CT Federal District Court</a>, April 28, 2022 <a href="/amicus-brief/2022-02-01-amicus-brief-aha-others-file-amicus-brief-7th-circuit-case-prep-act" target="_blank">Amicus Brief: AHA, Others in 2nd Circuit Case on PREP Act Immunity</a>, January 31, 2022 <a href="/amicus-brief/2022-01-03-amicus-brief-aha-others-2nd-circuit-case-prep-act-immunity-january-3-2022" target="_blank">Amicus Brief: AHA, Others in 2nd Circuit Case on PREP Act Immunity</a>, January 3, 2022 <a href="/amicus-brief/2021-11-02-aha-hap-amicus-brief-concurrent-and-overlapping-surgeries-november-1-2021" target="_blank">AHA, HAP Amicus Brief on Concurrent and Overlapping Surgeries</a>, November 1, 2021 <a href="/amicus-brief/2021-10-14-amicus-brief-aha-others-re-william-beaumont-hospital-vs-united-states" target="_blank">Amicus Brief: AHA, Others Re: William Beaumont Hospital vs United States of America, Ex Rel. David L. Felten, M.D., PH.D.</a>, October 14, 2021 <a href="/amicus-brief/2021-09-22-aha-aamc-amicus-brief-federal-trade-commission-vs-hackensack-meridian">AHA, AAMC Amicus Brief: Federal Trade Commission vs Hackensack Meridian Health, Inc, Et Al</a> September 22, 2021 <ul> <li><a href="/amicus-brief/2021-09-22-amicus-brief-nj-hospital-association-re-federal-trade-commission-v">NJ Hospital Association Amicus Brief: FTC v. Hackensack Meridian Health, Inc. and Englewood Healthcare Foundation</a> September 22, 2021</li> </ul> <a href="/amicus-brief/2021-09-13-amicus-brief-academic-medical-centers-support-aha-340b-case-september-10">Amicus Brief: Academic Medical Centers Support AHA in 340B Case</a>,&nbsp;September 10, 2021 <a href="/amicus-brief/2021-09-13-amicus-brief-state-and-regional-hospital-associations-express-support-ahas">Amicus Brief: State and Regional Hospital Associations Express Support for AHA’s 340B Case</a>, September 9, 2021 <a href="/amicus-brief/2021-08-11-amicus-brief-aha-others-file-5th-circuit-case-prep-act-immunity">Amicus Brief: AHA, Others File in 5th Circuit, Case On PREP Act Immunity</a>, August 10, 2021 <a href="/amicus-brief/2021-07-27-amicus-brief-aha-others-file-11th-circuit-case-prep-act-immunity-july-27">AHA, Others File in 11th Circuit Case on PREP Act Immunity</a>, June 27, 2021 <a href="/amicus-brief/2021-06-24-amicus-brief-eli-lilly-v-cochran-re-340b-contract-pharmacy-intervention ">Amicus Brief Eli Lilly v Cochran Re 340B Contract Pharmacy – Intervention</a>,&nbsp;&nbsp;June 23, 2021 <a href="/2021-06-24-amicus-brief-novo-nordisk-v-cochran-re-340b-contract-pharmacy-intervention">Amicus Brief NOVO NORDISK v Cochran Re 340B Contract Pharmacy – Intervention,</a> June 22, 2021 <a href="/2021-06-17-amicus-brief-aha-others-urge-9th-circuit-court-appeals-affirm-decision-holding-prep-act">Amicus Brief: PREP Act, AHA, Others Support Decision Providing Broad Immunity from Tort Liability,</a> June 16, 2021 <a href="/amicus-brief/2021-09-29-aha-national-associations-amicus-brief-340b-contact-pharmacy-legal">AHA, National Associations Amicus Brief – 340B Contact Pharmacy Legal Challenge by Sanofi</a> June 15, 2021 <a href="/2021-05-28-amicus-brief-pasadena-hospital-assn-ltd-dba-huntington-hospital-and-cedars-sinai-health">Amicus Brief: Pasadena Hospital Assn Ltd. d/b/a Huntington Hospital, and Cedars-Sinai Health System v. California Department of Justice; Hospital Associations support challenge to conditions placed on hospital affiliation,</a> May 27, 2021 <a href="/amicus-brief/2020-11-04-amicus-brief-arizona-opioid-case">Amicus Brief: Arizona Opioid Case</a>, November 4, 2020 <a href="/amicus-brief/2020-07-24-us-chamber-amicus-brief-negotiated-charges-appeal-july-24-2020">US Chamber Amicus Brief in Negotiated Charges Appeal</a>, July 24, 2020 <a href="/amicus-brief/2020-07-24-hospital-associations-amicus-brief-negotiated-charges-appeal-july-24-2020">Hospital Associations Amicus Brief in Negotiated Charges Appeal</a>, July 24, 2020 <a href="/amicus-brief/2020-07-02-amicus-brief-9th-circuit-urged-reverse-fca-decision-based-primarily">Brief of Amici Curiae the �� Association, the California Hospital Association, and the Washington State Hospital Association in Support of Defendants-Appellants Re: 9th Circuit Urged to Reverse FCA Decision Based Primarily on Statistics</a>, July 2, 2020 <a href="/amicus-brief/2020-05-13-amicus-brief-36-state-hospital-associations-support-petitioners">Amicus Brief: 36 State Hospital Associations in Support of Petitioners</a>, May 13, 2020 <a href="/amicus-brief/2020-05-13-amicus-brief-national-hospital-associations-support-california-state">Amicus Brief: National Hospital Associations in Support of the California State Coalition and House of Representatives</a>, May 13, 2020 <a href="/amicus-brief/2020-04-13-amicus-brief-aha-others-urge-supreme-court-review-3rd-circuit-fca-decision">Brief of �� Association, Association of American Medical Colleges, Federation of ��s, Hospital and Healthsystem Association of Pennsylvania, and New Jersey Hospital Association as Amici Curiae in Support of Petitioners Re:&nbsp;3rd Circuit FCA Decision,</a> April 13, 2020 <a href="/amicus-brief/2020-02-28-us-chamber-commerce-files-amicus-brief-supporting-legal-challenge-rule">US Chamber of Commerce Files Amicus Brief Supporting Legal Challenge to Rule Requiring Disclosure of Negotiated Charges</a>, February. 28. 2020 <a href="/amicus-brief/2020-01-15-amici-curiae-brief-aha-and-national-hospital-associations-support">Amici Curiae Brief of the AHA and National Hospital Associations in Support of the Petitioners (United States House of Representatives) v. State of Texas, et al. on Petitions for Writ of Certiorari to the United States Court of Appeals for the Fifth Circuit</a>, January 15, 2020 <a href="/2019-11-14-amicus-brief-aha-federation-nlrb-standards-governing-offensive-employee-conduct">Amici Curiae Brief of AHA, Federation on National Labor Relations Board Standards Governing Offensive Employee Conduct</a>, November 12, 2019 <a href="/amicus-brief/2019-10-23-motion-file-amicus-brief-stark-law-oct-22-2019">Amici Curiae Brief of the �� Association and other hospital groups on the Stark Law</a>, October 22, 2019 <a href="/amicus-brief/2019-09-13-amici-curiae-brief-american-hospital-association-and-other-hospital-groups">Amici Curiae Brief of the �� Association and other hospital groups on DHS’s Public Charge Rule</a>, September 13, 2019 <a href="/amicus-brief/2019-09-11-amici-curiae-brief-american-hospital-association-and-other-hospital-groups">Amici Curiae Brief of the �� Association and Other Hospital Groups on DHS’s Public Charge Rule</a>, September 11, 2019 <a href="/amicus-brief/2019-02-13-amicus-brief-aha-and-federation-american-hospitals">Amici Curiae Brief of the �� Association and Federation of ��s</a>, February 13, 2019 <a href="/system/files/2018-12/12-20-2018-amici-brief-allina.pdf">Amici Curiae Brief of the �� Association, Federation Of ��s, And Association Of American Medical Colleges in Medicare DSH Case</a>&nbsp;December 20, 2018 <a href="/system/files/2018-11/181130-amicus-brief-medical-liability.pdf">Amici Curiae Brief of the North Dakota Medical Association, North Dakota Hospital Association, �� Association and American Medical Association</a>, Nov. 30, 2018 <a href="/system/files/2018-10/181004-amicus-brief-aha-fah-caesars-nlrb.pdf">FINAL AHA-FAH Amici Brief (Caesars Entertainment Corp.)</a>, October 4, 2018 <a href="/system/files/2018-09/180920-amicus-brief-physicians-opioid.pdf">Amicus brief: AHA asks court to remove physicians from centralized opioid litigation</a>, September 20, 2018 <a href="/system/files/2018-07/180713-amicus-brief-palo-alto-price-controls-initiative.pdf">Amicus curiae brief in support of Petitioners’ request that the Court remove the Palo Alto Accountable and Affordable Care Initiative from Palo Alto’s November 6, 2018 ballot </a>July 13, 2018 <ul> <li><a href="/system/files/2018-07/180713-application-for-leave-palo-alto-intiative.pdf">Application for Leave to File Amicus Brief</a></li> </ul> <a href="/amicus-brief/2018-06-14-amici-curiae-brief-re-aca-repeal">Amici Curiae Brief: Hospital Groups Urge Court to Reject Latest ACA Challenge</a>, June 14, 2018 <a href="/amicus-brief/20180329-amicus-brief-opposition-consolidation ">Amicus Brief in Opposition to Consolidation</a> March 29, 2018 <ul> <li><a href="/legal-documents/20180329-application-leave-file-amicus-brief-opposition-consolidation">Application for Leave to File Amicus Brief</a></li> </ul> <a href="/amicus-brief/2018-02-22-hospital-associations-amicus-brief-340b-appeal-feb-22-2018">Amicus Brief: Hospital Associations' 340B Appeal</a> February 22, 2018 <a href="/content/17/171208-amicus-brief-associations-340b.pdf">Amicus Brief: Hospital Associations Supporting 340B lawsuit</a> December 8, 2017 <a href="/content/17/171021-amicus-ca-vs-trump-et-al.pdf">Amicus Brief: State of California, et al. v. Donald J. Trump, et al, </a>October 23, 2017 <a href="/content/17/170706-amicus-brief-southern-baptist.pdf">Amicus Brief: Southern Baptist Hospital of Florida, Inc. v. Jean Charles, Jr.,</a> July 6, 2017 <a href="/content/17/170316-amicusbrief-anthem.pdf">Amicus Brief: USA, et al. v. Anthem, et al.; No. 17-5024</a>, March 16, 2017 <ul> <li><a href="/content/17/170316-intenttopartic-anthem.pdf">&nbsp;Notice of Intent to Participate as Amicus Curiae</a></li> </ul> <a href="/content/16/161031-aha-amicus-housevburwell-hospitals-cadc.pdf">Amicus brief: House v. Burwell, </a>October 31, 2016 <a href="/content/16/161025-aha-brief-amicus-curiae.pdf">Amicus brief: United States of America ex rel. Bernsten v. Prime Healthcare Services, Inc. et al.</a>, October 25, 2016 <a href="/content/16/160901-aha-amici-brief.pdf">Amicus brief: Carle Foundation v. Illinois Department of Revenue</a>, August 30, 2016 <a href="/content/16/160808-amici-brief-mergers.pdf">Amicus brief: Federal Trade Commission et al. v. Advocate Health Care Network et al</a>, August 8, 2016 <a href="/content/16/160614-amicusbrief-nlrb.pdf">Amicus brief in Appeal of Browning Ferris Industries of CA: NLRB’s Expansive Joint Employer Test</a>, June 14, 2016 <a href="/content/16/160324-amicibrief.pdf">AHA, CHAUSA say no to extrapolation in FCA cases</a>, March 24, 2016 <a href="/content/16/160127-aha-amici-brief.pdf ">AHA, others urge Supreme Court to reverse decision expanding FCA liability,</a> January 27, 2016 <a href="/content/16/160113-amicusbrf-nlrb.pdf">AHA et al amicus brief urging court to overturn NLRB order threatening peer review confidentiality</a>, Jan. 13, 2016 <a href="/content/15/150918-amicusnlrb.pdf">AHA/FAH Amicus Brief urging NLRB to affirm long-standing position on inclusion of “jointly employed” employees in bargaining units, </a>Sept. 18, 2015 <a href="/content/15/150904-amicus-gobeille-liberty.pdf">Amicus Brief in Gobeille v. Liberty Mutual Insurance Co., </a>Sept. 4, 2015 <a href="/content/15/150630-amicus-rushnlrb.pdf">AHA, FAH support overturning NLRB decision that allows incumbent unions to organize in piecemeal fashion</a> June 29, 2015 <a href="/content/15/152004-aha-amici-brief.pdf">AHA files amicus brief on Petition for a Writ of Certiorari to the Kentucky Supreme Court</a>, April 20, 2015 <a href="/content/15/150311-aha-amici-brief.pdf">AHA files amicus brief in Support of Petitioner ProMedia Health System, Inc. v. FTC</a>, March 11, 2015 <a href="/content/15/150128-amicus-14-114.pdf">AHA, others file friend-of-the-court brief in King v. Burwell</a>, January 28, 2015 <a href="/content/15/150121-amici.pdf">Amicus Brief in Support of Petitioner in ProMedica Health System, Inc. v. FTC, No. 14-762</a>, January 21, 2015 <a href="/content/15/150501-aha-amici-brief.pdf">AHA, FAH urge Supreme Court to affirm 9th Circuit ruling in Medicaid case</a>, January 5, 2015 <a href="/content/15/150209-aha-amici-brief.pdf">AHA urges court to reject challenge to 340B orphan drug interpretive rule</a>, February 6, 2015 <a href="/content/14/141103-aha-amici-brief.pdf">Hospital groups urge full D.C. Circuit to uphold premium subsidies nationwide</a>, November 3, 2014 <a href="/content/14/141017-aha-amici-brief-irs.pdf">Supreme Court urged to scrutinize use of interpretive rules</a>, October 17, 2014 <a href="/content/14/140910amicusbriefky.pdf">Amicus Brief in Support of Appellants' Petition for Rehearing by the �� Association, Kentucky Hospital Association, Kentucky Medical Association, Kentucky Chamber of Commerce and the Individual Kentucky Hospitals</a>, September 10, 2014 <a href="/content/14/140905-aha-amici-curiae-brief.pdf">AHA, others file friend-of-the-court brief in Supreme Court FCA case</a>, September 5, 2014 <a href="/content/14/140626-amicus-browningferris.pdf">Amicus brief in Browning-Ferris Industries of CA:&nbsp; Standard for Determining Joint Employer Status</a>, June 26, 2014 <a href="/content/14/140624-aha-amici-curiae-brief.pdf">AHA, others urge Supreme Court to bar excessive FCA penalties</a>, June 23, 2014 <a href="/content/14/140617-aha-amicus-brief.pdf">Amicus&nbsp; Brief in Purple Communications:&nbsp; Use of Employers' Electronic Communications Systems</a>, June 16, 2014 <a href="/content/14/140221-aha-amici-brief.pdf">AHA files amicus brief in appeal of 'observation' lawsuit</a>, February 20, 2014 <a href="/content/14/140210-aha-amici-curiae-brief.pdf">Associations to NLRB: Confidentiality critical to effective peer review</a>, February 10, 2014 <a href="http://www.aha.org/content/13/131213-aha-amicus-curiae-brief.pdf">AHA urges court to reject challenge to 340B orphan drug rule, </a>December 13, 2013 <a href="http://www.aha.org/content/13/131211-aha-amicus-brief.pdf">AHA supports SC health system in Stark Law appeal</a>, December 11, 2013 <a href="http://www.aha.org/content/13/131113-amicus-brief-aha-hhs.pdf">Amicus Brief: AHA In Suppport of Defendants -&nbsp;Halbig et al. v. Sebelius, </a>November 13, 2013 <a href="/content/13/130312-amicusbrief.pdf">Amicus Brief: University of Texas Southwestern Medical Center v. Nassar</a>, March 12, 2013 <a href="/content/13/130208-aha-amicus-brief.pdf">Amicus Brief: Hospital groups urge court to review CA Medicaid ruling</a>, February 8, 2013 <a href="/content/12/121023-aha-amicus-curiae-brief.pdf">Amicus Brief in Supreme Court Medicare DSH case</a> <a href="/content/12/120424-amicus-floridahosp.pdf">Amicus Brief supporting motion to dismiss: OFCCP, Department of Labor v. Florida Hospital of Orlando</a> <a href="/content/12/121019-arbdecis-ofccpvflorhosp.pdf">The Department of Labor's Administrative Review Board overturns</a>&nbsp;an administrative law judge's ruling that Florida Hospital of Orlando is a federal subcontractor because it is a TRICARE in-network provider, October 19, 2012 <a href="/content/12/120924-amicus-promedica.pdf">AHA files Amicus Brief with U.S. Court of Appeals supporting ProMedica Health System, Inc</a>. <a href="/content/12/120427-aha-amici-brief.pdf">AHA files amicus brief in "Observation" lawsuit </a>April 27, 2012 <a href="/content/12/120217-aha-amici-brief.pdf">Hospital groups file amicus brief supporting ACA Medicaid expansion </a>February 17, 2012 <a href="/content/12/120207-amici-nlrbfinalelecrule.pdf">Amici Brief supporting challenge to NLRB's Final Election Rule </a>February 7, 2012 <a href="/content/12/120113-aha-amici-brief.pdf">Hospital groups file brief supporting ACA individual mandate </a>January 13, 2012 <a href="http://www.aha.org/content/12/120105-aha-amici-brief.pdf">Hospital Groups File Brief on Severability of ACA's Individual Mandate </a>January 6, 2012 <a href="/content/11/111221-amicus-aha-colorado.pdf">AHA Brief Urging Court to Uphold CO Decision to Opt Out of CRNA Supervision</a> AHA friend-of--the-court brief supporting the Colorado governor's decision to opt out of Medicare's physician supervision requirement for certified registered nurse anesthetists to improve access to care for rural residents. December 21, 2011 <a href="/content/11/111212-amicus-oha-ruthervkaiser.pdf">AHA, Hospital and physician groups file brief in support of OH liability law</a> The AHA, Ohio Hospital Association and other organizations today filed a joint friend-of-the-court brief in the Ohio Supreme Court in a case challenging a state law that prevents medical liability cases from being filed more than four years after the date of an alleged incident. (No. 2011-0899), December 12, 2011 <a href="/content/11/111027-aha-amici-brief.pdf">AHA, Hospital Groups File Brief in Support of Federal Petitioners</a> AHA, hospital groups file a&nbsp;brief in 11th Circuit in support of federal petitioners and urges the court&nbsp; to&nbsp;grant the Government's petition for certiorari and hold that the ACA is a constitutional exercise of Congress's Commerce Clause power. (No. 11-398 ), October 27, 2011 <a href="/content/11/110408-amicus.pdf">Hospital groups file ACA amicus brief</a> AHA, hospital groups file ACA amicus brief in 11th Circuit urging constitutionality of the individual mandate. (Nos. 11-11021 &amp; 11-11067), April 8, 2011 AHA, other groups'&nbsp;<a href="/content/11/110321-amicus.pdf">letter</a> urge U.S. to file supporting ACA amicus in Supreme Court Medicaid case, March 21, 2011 <a href="/content/11/110308-amici-specialty.pdf">AHA and ASHHRA Amici Brief</a> To the NLRB in support of Specialty Healthcare and Rehabilitation Center of Mobile&nbsp;opposing any modifications&nbsp;to&nbsp;procedures and standards for determining appropriate bargaining units that could erect obstacles to integrated care delivery, (No. 15-RC-8773), March 8, 2011 <a href="/content/11/110308-CDWamici.pdf">Coalition for a Democratic Workplace's Amici Brief</a> &nbsp; AHA, other hospital groups file ACA&nbsp; <a href="/content/11/110307-amicus.pdf">amicus brief</a> Commonwealth of Virginia, ex rel. Kenneth T. Cuccinelli, II, v. Kathleen Sebelius, U.S. Court of Appeals for the Fourth Circuit,&nbsp;(Nos. 11-10157 &amp; 11-1058) [ACA], March 7, 2011 AHA, other hospital associations file ACA&nbsp; <a href="/content/11/110225-amicus.pdf">amici brief</a> Liberty University, et al, v. Timothy Geithner, et al, Fourth Circuit Court of Appeals (No. 10-2347), [ACA], February 25, 2011 <a href="/content/11/110126-amicus-palomar.pdf">AHA, FAH, and AHCA Amicus Brief</a> Amicus brief in support of Appellant Palomar Medical Center re: CMS contractor's&nbsp;"good cause" to reopen claims (No. 10-56529), January 26, 2011 AHA, other hospital associations file <a href="/content/11/110121-amicus-T-More.pdf">amici brief</a> in ACA case Thomas More Law Center, et al., v. Barack Obama, et.al., U.S. Court of Appeals for the Sixth Circuit (No. 10-2388), [PPACA], January 21, 2011 <a href="/content/11/110111-amicus-Tuomey.pdf">AHA FCA Amicus Brief</a> U.S. Ex Rel., Michael K. Drakeford, M.D. v. Tuomey Healthcare System, Inc., U.S. Court of Appeals for the Fourth Court (No. 10-1819), January 10, 2011 <a href="/content/11/110107-amicus.pdf">AHA and ASHHRA Amici Brief</a> Roundy's Inc. and Milwaukee Building and Construction Trades Council, AFL-CIO: AHA and ASHHRA to the NLRB in support of the respondent employer (No. 30-CA-17185), January 7, 2011 <a href="/content/11//101229-amicus.pdf">AHA Amicus Brief</a> Office of Federal Contract Compliance Programs, Department of Labor v. Florida Hospital of Orlando, Department of Labor, Administrative Review Board (No. 11-011), December 29, 2010 <a href="/content/11/101206-amicus-brief.pdf">AHA FCA Amicus Brief</a> AHA joined the U.S. Chamber of Commerce and the Pharmaceutical Research and Manufacturers of America in Schindler v. U.S. ex rel Kirk, U.S. Supreme Court, No. 10-188 [FCA] December 6, 2010 <a href="/content/11/101129-amicus-brief.pdf">Motion by the AHA for leave to file an Amicus Brief</a> Office of Federal Contract Compliance Programs, Department of Labor v. Florida Hospital of Orlando, November 29, 2010 <a href="/content/11/101119-amicus-Fla-ACA.pdf">AHA other hospital groups file ACA&nbsp;Amicus Brief</a> State of Florida, by and&nbsp;through Bill McCollum et al.,&nbsp;v United States Department of Health and Human Services, et al., (District Court for the Northern District of Florida Pensacola Division Case No. 3:10-cv-91-RV/EMT) November 19, 2010 <a href="/content/11/101111-Amicus-Florida.pdf">Motion to File Joint</a>&nbsp;ACA <a href="/content/11/101111-Amicus-Florida.pdf">Amicus Brief</a> By AHA, AAMC, CHA, FAH, NACH and NAPHHS motion filed federal district court RE: State of Florida v.&nbsp;DHHS (District Court for the Northern District of Florida No. 3:10-cv-91-RV/EMT)&nbsp;[Re: Lawsuit challenging health reform law] November 11, 2010 <a href="/content/11/100813-amicus.pdf">AHA Amicus Brief</a> &nbsp;-- See&nbsp;<a href="/content/11/110111mayodecision.pdf">Supreme Court Decision, January 11, 2011</a> Mayo Foundation for Medical Education and Research et al., v. United States, U.S. Supreme Court (No. 09-837) [Re: Student Exemption from FICA tax], August 13, 2010&nbsp; <a href="/advocacy-issues/letter/2010/100806-let-healthgroups-solgen.pdf">AHA Letter to Solicitor General</a> Maxwell-Jones v. Independent Living Center (No. 09-958) [Cut in Medicaid payments for hospitals and other providers]. Letter urging Solicitor General to recommend denial of review by the U.S. Supreme Court, August 6, 2010&nbsp; <a href="/content/00-10/100216-amicus-mayo.pdf">AHA Amicus Brief</a> Mayo Foundation for Medical Education and Research et al., v. United States: Petition for Certiorari to the U.S. Supreme Court (No. 09-837) [Re: Student Exemption from FICA tax] February 16, 2010 <a href="/content/00-10/100104-amicus.pdf">AHA Amicus Brief</a> Ortho Biotech Product, L.P. v. U.S. Ex Rel. Mark Eugene Duxbury, U.S. Supreme Court (No. 09-654) [Re: False Claims Act] January 4, 2010 <a href="/content/00-10/090903-amicus-brief-GC.pdf">AHA Amicus Brief</a> Graham County Soil &amp; Water Conservation District, et al., v. United States Ex Rel., U.S. Supreme Court (No. 08-304) [Re: False Claims Act] September 3, 2009 <a href="/content/00-10/090903-amicus-brief-GA.pdf">AHA Amicus Brief</a> &nbsp;-- See Georgia Supreme Court <a href="/content/00-10/10325-amicus.pdf">Decision</a>, March 22, 2010 Atlanta Oculoplastic Surgery v. Betty Nestlehutt and Bruce Nestlehutt, Supreme Court of Georgia (S09A1432) [medical liability and non-economic damages] August 21, 2009 <a href="/content/00-10/090204-amicus-brief.pdf">AHA Amicus Brief</a> -- See Sup. Ct.&nbsp; <a href="/content/00-10/100318-provenasupct-decision.pdf">Decision</a>, March 18, 2010 Provena Covenant Medical Center v. the Department of Revenue of the State of Illinois, (Sup. Ct. Court of Illinois No. 107328) [Re: property taxes] February 4, 2009 <a href="/content/00-10/081021-amicus-brief.pdf">AHA Amicus Brief</a> Wellstar Health System v. Cheon Park and Lynn Park, Supreme Court of Georgia, (No. S08A1936), [medical liability and non-economic damages] October 21, 2008 <a href="/advocacy-issues/legal/080508-amicus-brief.pdf">AHA Amicus Brief</a> LeBron v. Gottlieb Memorial Hospital, Illinois Sup. Ct., No. 105741 &amp; 105745 (cons.) [caps on noneconomic damages] May 8, 2008 <a href="/content/00-10/080129-amicusbrief.pdf">AHA Amicus Brief</a>&nbsp;-- See Appellate Court <a href="/content/00-10/080827-Provena-Appell-Dec.pdf">Decision</a>, August 26, 2008 Provena Medical Center&nbsp;v.&nbsp;Ct. of Appeals (Court of Appeals No. 4-07-0763) [property taxes] January 28, 2008 <a href="/content/2008/pdf/080116-amicusbrief.pdf">AHA Amicus Brief</a>&nbsp;-- See Sup. Ct.&nbsp; <a href="/content/00-10/080619-laboropinion.pdf">Decision</a>, June 19, 2008 Chamber of Commerce v. Edmund G. Brown, Jr., Et Al.,&nbsp;(No. 06-939) [labor relations] Jan. 16, 2008 <a href="/system/files/advocacy-issues/legal/07214-amicus-brief.pdf">AHA Amicus Brief</a>&nbsp;-- See Sup.&nbsp;Ct.&nbsp; <a href="/content/2008/pdf/080609-amicusbrief.pdf">Decision</a>, June 9, 2008 Allison Engine Company, Inc., et al., v. United States ex Rel., US Sup.&nbsp;Ct.&nbsp;(No. 07-214) [False Claims Act] Dec. 20, 2007 <a href="/content/00-10/071120-amicus.pdf">AHA Amicus Brief</a> Houston Medical Center&nbsp;v.&nbsp;Adkins, US Sup. Ct.&nbsp;(No. 07-538) [peer review privilege] November 21, 2007 <a href="/content/00-10/070808-amicus-brief.pdf">AHA Amicus Brief</a> &nbsp; See 5th Cir. Ct.&nbsp;of Appeals <a href="/content/00-10/080724-courtdec.pdf">Decision</a>, July 23, 2008 Poliner v. Texas Health Systems, et al.: US&nbsp;Ct.&nbsp;of Appeals for the Fifth Circuit [peer review] August 8, 2007 <a href="/content/00-10/07-08-08-amicus-brief-DiCarlo.pdf">AHA Amicus Brief</a> DiCarlo v. St. Mary Hospital, et al.: US Ct.&nbsp;of Appeals for the Third Circuit [billing and collection] August 8, 2007. <a href="/content/00-10/070608-amicus-brief.pdf">AHA Amicus Brief</a> US Ex Rel. Rost v. Pfizer US Ct.&nbsp;of Appeals [False Claims Act: “public disclosure bar”] June 7, 2007 <a href="/advocacy-issues/legal/06939-amicus-brief.pdf">AHA Amicus Brief</a> Chamber of Commerce of the U.S. v. Edmund G. Brown, Jr., et al.: Petition for Certiorari US Sup. Ct. (No. 06-939) [labor relations] March 9, 2007. <a href="/advocacy-issues/legal/000597-amicus-brief.pdf">AHA Amicus Brief</a> Provena Covenant Medical Center vs. Department of Revenue of the State of Illinois, (2006-MR-000597) [Illinois Department of Revenue final administrative decision denying property tax exemption] March 9, 2007 <a href="/advocacy-issues/legal/061026-amicus-brief.pdf">AHA Amicus Brief</a>&nbsp;-- See Sup.&nbsp;Ct.&nbsp; <a href="/content/00-10/05-1272rockwell.pdf">Decision</a>, March 27, 2007 Rockwell v. U. S. ex rel. Stone, US Sup. Ct. [False Claims Act]&nbsp;October 26, 2006 including&nbsp;<a href="/content/00-10/wydenltr.pdf">letter</a>&nbsp;to Senator Wyden <a href="/advocacy-issues/legal/060811-amicus-brief.pdf">AHA Amicus Brief</a> Gibson, et al,&nbsp;v. Virginia Mason Medical Center [challenge to hospitals' billing practices] August 11, 2006 <hr /> <a href="litigation.shtml">Click here for AHA Resources: AHA Litigation</a> </div> </div> </div> Tue, 16 Aug 2022 13:58:47 -0500 Legal Live Analysis: Supreme Court Hears Oral Arguments in CMS and OSHA Vaccine Mandate Cases January 7, 2022 /legal/2022-01-07-live-analysis-supreme-court-hears-oral-arguments-cms-and-osha-vaccine-mandate <div class="container"> <div class="row"> <div class="col-md-8"> <h2>Key Insights from the Oral Arguments Before the Supreme Court in Vaccine Mandate Cases</h2> The U.S. Supreme Court January 7, 2022, held oral arguments on whether to allow the Centers for Medicare &amp; Medicaid Services’ and Occupational Safety and Health Administration’s vaccine mandates to go into effect while appeals are heard in the courts of appeals. Sean Marotta, a partner at Hogan Lovells and AHA outside counsel, provided real-time analysis of the oral arguments and a recap of the key takeaways. <div class="row"> <div class="col-md-6"> <div class="external-link spacer"><a class="btn btn-wide btn-primary" href="https://threadreaderapp.com/thread/1479501392654090244?refresh=1641581508" target="_blank" title="Click here to view the full Twitter thread on the CMS vaccine mandate Supreme Court cases oral arguments.">View the Complete CMS Case Twitter Thread</a></div> </div> <div class="col-md-6"> <div class="external-link spacer"><a class="btn btn-wide btn-primary" href="https://threadreaderapp.com/thread/1479465947874398212.html" target="_blank" title="Click here to view the full Twitter thread on the OSHA vaccine mandate Supreme Court cases oral arguments.">View the Complete OSHA Case Twitter Thread</a></div> </div> </div> <hr /> <h3>Supreme Court Oral Arguments in the CMS Vaccine Mandate Case</h3> Here is the thread for the #CMS vaccine mandate argument, which is starting now. First up is Brian Fletcher, the principal deputy solicitor general, who is arguing for CMS. /1 Fletcher argues that vaccination of medical staff is best way to protect Medicare and Medicaid beneficiaries and that CMS carefully considered and rejected fear of staffing shortages and alternatives. /2 In response to a Justice Thomas question, Fletcher says CMS did not rely on just general rulemaking authority but also specific statutory authority for each category of healthcare provider. Trying to head off criticism of OSHA's actions. /3 Fletcher admits that vaccine mandate from #CMS is new, but that COVID is unprecedented. /4 Roberts asks whether relationship between agency and regulation is closer for CMS and OSHA. Asks which is most-acute danger: CMS, OSHA, or contractors. Suggests that government is just trying to use any power it has, not address targeted dangers. /5 But Roberts does seem to concede that the healthcare setting presents more-acute risks to patients than to workers generally or federal contractors. Fletcher doesn't want to undermine other mandates, but also wants to hold the line for CMS. /6 Sotomayor with a friendly question that this is a spending-clause case rather than a Commerce Clause case. Federal government can decide how to spend its funds. Fletcher, of course, agrees. /7 Fletcher points out that CMS imposes intrusive, expensive compliance obligations all the time. This is not unusual. /8 Alito asks whether States had clear notice that accepting Medicaid money would subject them to this sort of requirement. Fletcher replies that States had notice they need to comply with CMS regulations, which can and do change all the time. /9 Alito and Fletcher tangle over whether specific authorizations he is relying on actually confer power or are just definitional sections. /10 Alito asks where the line is on CMS' powers. Fletcher points out that professional organizations, including @ahahospitals, are recommending vaccination policies and thus this requirement is reasonable. /11 Barrett jumps in and asks about the facility-specific statutes. She says each of those statutes are different and says that not all of them refer to health and safety. Says, for instance, skilled nursing facilities statute is stronger than ambulatory surgical centers. /12 Barrett asks what happens if she thinks some of the statutes can support a vaccine mandate and not others. What does she do since this is an omnibus rule? /13 Fletcher divides statutes into those that mention health and safety and those that don't. Says case is clear where health and safety is mentioned. For those where it is not, which is 3% of covered workers, there are still textual clues supporting mandate. /14 Barrett seems to be asking whether she can stay the district court injunctions as to some categories of providers or whether, if not all facilities can have a vaccine mandate, the injunctions have to remain in place in total. /15 Fletcher says that the regulation is severable and that if the Court is not satisfied that all facilities can be covered, then it should stay the district court injunctions as to those that can be. /16 Sotomayor lets Fletcher go back to his core theme: If the power to set conditions of participation on facilities means anything, it means you can protect beneficiaries from contracting highly infectious diseases from healthcare workers. /17 The Court is a lot quieter in this argument. Does it mean that the Court is just tired from two hours of OSHA? Or is the Court more-likely to allow the CMS mandate? We'll see when the challengers begin their arguments. /18 Fletcher is given room to run without questions on staffing shortages. Argues that CMS reasonably found that healthcare already has high turnover and that any additional turnover from the CMS mandate is minimal. /19 Kagan asks about the lack of notice and comment and whether Secretary had sufficient time to develop the rule with public participation. Fletcher says no because of all of the work that goes into crafting the interim final rule. /20 Gorsuch brings up statutory prohibition on controlling tenure of staff. Suggests that putting facilities to choice of receiving money or firing staff essentially does that. /21 Fletcher says that prohibition means "don't hire that person, do hire this person." Gorsuch asks whether the prohibition can be read as he seems to read it. Fletcher says it's possible, but not the most-natural reading. Says that statute allows standard setting. /22 For example, a hospital must be staffed by doctors. That does control who is hired. Gorsuch says that it's a range; some things are controlling administration and others are not. Fletcher says wherever the line is, this falls on the right side of it. /23 Gorsuch replies that CMS has never used standard-setting power to require vaccines before. Asks whether CMS can require doctors to get enough sleep or take their vitamins. /24 Fletcher says there may be problems with those requirements, but not because they are control over an employee's tenure or hiring. /25 Kavanaugh asks Fletcher to explain how costs are being borne mostly by federal government. Fletcher replies that government is covering cost of vaccines. /26 Kavanaugh asks why CMS does not require other vaccines, such as flu or childhood diseases. Fletcher says that CMS reasonably concluded that COVID is more dangerous than flu and that other vaccines do not need a CMS standard because they are routinely vaccinated anyway. /27 Kavanaugh seems satisfied by Fletcher's answers. Barrett is back to the particular-facility statutory provisions. Fletcher says facility-specific is sufficient even without general regulatory grand to CMS. /28 Missouri's Deputy Solicitor General Jesus Osete is now up representing one coalition of challengers. Says that CMS is relying on "vague" provisions "scattered throughout" the Social Security Act. /29 Based on Fletcher's argument, however, it is clear that the Court sees the CMS mandate as less of a regulatory overreach. There may be statute-specific reasons to question it, but it does not implicate the same separation-of-powers, who-decides issues as the OSHA mandate. /30 Thomas asks about the States' standing to challenge the mandate. Osete says that States have variety of bases to challenge the mandate, including as proprietor of state-run facilities. /31 Roberts asks about the Spending Clause context; this is about spending federal funds and States signed the contract. Osete says that conditions of participation must come from unambiguous text and text there is not unambiguous. No mention of vaccination. /32 Kagan is incredulous. Asks whether CMS is a mere bookkeeper and has no authority to protect vulnerable populations. /33 Kagan emphasizes that the elderly and the poor are "especially vulnerable" to COVID and that it is a "principal responsibility" of CMS to protect. /34 Kagan and Osete spar over whether CMS can require infection control measures. Osete says that is expressly allowed. Kagan asks whether he really is arguing that infection prevention requires express language. Osete dodges. /35 Osete is getting pummeled by the liberal justices and no one is coming to his aid. But the conservative justices tend to hold back more in the free-for-all questioning portion. /36 Kagan: "One thing you have to do is not kill your patients. That seems like a pretty basic infection control measure." Osete says that vaccinations are within States' province. Congress needs to be clear. /37 Breyer is back to the public interest, saying why the public interest does not compel staying the district court injunctions so that rising cases can be stopped. /38 Osete pivots to staffing shortages, arguing that it is worse for patients if rural hospitals are short staffed because staff quits rather than be vaccinated or seek an exemption. /39 Osete says that mandate will "devastate local communities" that "do not draw their pool of applicants from the coasts." Says that their views should be considered through public input. Kagan says CMS considered and rejected that argument based on the data it has. /40 Kagan says that CMS had to balance all the data and make a decision in light of duty to protect beneficiary, including overcoming fear from those who do not want to receive services from unvaccinated staff. Why not defer to CMS expertise? /41 Sotomayor asks why government, as payor of services, cannot decide it only wants to pay for services at facilities where staff is vaccinated. /42 Osete is not having an easy time here, and no one on the conservative side is coming to bail him out, even in the justice-by-justice questioning. We will see if the Louisiana SG, Elizabeth Murrill, has it better or if this is a trend. /43 Justice Kavanaugh says "this is an unusual administrative law" experience because the people regulated, hospitals and healthcare providers, are not complaining, and in fact support it. He asks Osete what to make of that. /44 Osete says small providers do have a problem with it, and, anyway, States have their own facilities. Kavanaugh says "there is a missing element" in that there is no outcry from the vast majority of privately owned facilities. Osete says States speak for their citizens. /45 Kavanaugh, like the Chief, seems to think this is different than the OSHA case and far-more-defensible. Also asks why vaccines are different than wearing gloves. Osete says that vaccines are a "permanent medical procedure" that cannot come off when work is over. /46 We're now on to Elizabeth Murrill of Louisiana, who is arguing by phone. Her line is also staticky. She is the most anti-vaccine mandate advocate so far, calling vaccines an "invasive" medical procedure. /47 Murrill argues that mandate will "eviscerate informed consent" for healthcare workers. Again, a surprisingly anti-vaccine position from the route that the challengers have taken so far, particularly Keller. /48 Roberts asks whether Murrill agrees that COVID no longer poses the dire emergency it once did. Murrill says those are "shifting sands." Doesn't really answer question. /49 There is a fair bit of awkward dead air, where Murrill isn't arguing and no one is asking questions. Whether it is fatigue or just everyone thinks the issues have been ventilated adequately is unclear. /50 Roberts goes back to the Spending Clause context, asking why the requirement that States must comply with CMS regulations is not adequate notice of what they were getting into when they took Medicare and Medicaid money. /51 Murrill says that CMS' job is to provide funds, not to set standards for patient protection. More dead air. This is a very awkward leg of the argument. /52 I don't know why Murrill isn't filling in argument when we get silences. This isn't effective at all, even if you agree with her arguments. /53 Murrill arguing that the CMS mandate was a "pretext" and a "workaround." No one is engaging, even to jump on her. They're ready for lunch. (My sainted wife brought me lunch during the OSHA oral argument.) /54 Breyer loops back, emphasizing the public interest and equities, going on at some length, similar to as he did in the other arguments. /55 Murrill says the CMS mandate is different than the OSHA mandate because there is no mask-and-test opt-out and is "extraordinary" and "immediate" and requires a stay now. Murrill says existing infection-control measures are enough. /56 Sotomayor not sure how States have role to complain except as proprietors of state-run facilities. Notes providers are not complaining. Asks how this is different from the innumerable rules CMS has, from bed height to hand-sanitizer proximity. /57 Murrill says that they have standing as more than providers. Under Medicaid, States contract with facilities. Argues that power to "require the individual to submit to a medical treatment" has never been asserted. Again, surprisingly anti-vaccine. /58 And there is nothing on the justice-by-justice roll call. Brian Fletcher is up for rebuttal. /59 Fletcher argues that challengers seem to contend that "vaccines are different." Says that there is no basis for that in the statute, which is a federal-spending provision. States normally regulate medicine, but participants in Medicaid and Medicare need to comply with regs. /60 Fletcher also argues that fact vaccines are permanent isn't a relevant difference. Vaccines are ubiquitous in healthcare settings and COVID no different. Appeals to Barrett that all statutes support mandate, but that Court should rule statute by statute if necessary. /61 Fletcher notes that CMS will exercise discretion on a facility-by-facility level in enforcement. Will not just terminate a facility struggling in good faith to comply with the mandate. /62 And that's it. The applications are submitted and the gavel comes down. My take-away: It may be close, but I am tentatively predicting there are at least five votes to uphold the mandate in full and maybe six votes to uphold it in large portion. /Fin <hr /> <h3>Supreme Court Oral Arguments in the OSHA Vaccine Mandate Case</h3> Good morning and welcome to my live tweet of the #SCOTUS #VaccineMandate oral arguments, brought to you by @ahahospitals. We're nine minutes out from the Court taking the bench. First up today will be arguments on whether to stay the #OSHA vaccinate-or-test mandate. /1 All of the justices except Sonia Sotomayor will be in the courtroom for oral argument today. Justice Sotomayor, who is diabetic, will be participating from her Chambers by phone. Also, Ohio Solicitor General Ben Flowers will argue by phone as he tested positive for COVID. /2 We'll hear first from Scott Keller, who will argue for a coalition of businesses led by @NFIB. Then is Flowers for a coalition of States led by Ohio. And arguing for the government and in defense of OSHA will be U.S. Solicitor General Elizabeth Prelogar. /3 Remember from my preview post that although partisans on both sides will cheer questions from justices on "their" side, we are primarily worried about the "median" justices: The Chief Justice, Justice Kavanaugh, and Justice Barrett. Listen closely when they speak. /4 One logistical note: I'll have separate threads for the #OSHA and #CMS oral arguments to make it easier for those looking for one analysis or the other. Now we wait for Supreme Court Marshal Gail Curley to cry the court with the traditional "Oyez, oyez, oyez." /5 There's the buzzer and the gavel. The Chief Justice announces that Justice Sotomayor and Mr. Flowers are participating remotely. Mr. Keller is first up and will have a minute to speak uninterrupted. /6 Keller focuses on the #OSHA's effect on the national economy, including the Postal Service's request for an exemption, and the unprecedented nature of this mandate, noting that OSHA has never imposed a nationwide vaccine mandate before. /7 As is traditional, Justice Thomas asks the first question. He asks when the statutory standard for an emergency standard is met and gives Keller some room to run in answering that it must be a nationwide threat specific to workplaces. /8 As expected, Justice Thomas' questions signal that he thinks that an emergency standard is unnecessary and that public participation should have been provided on the #OSHA mandate before it was issued. /9 Justice Kagan jumps in. Asks why the mandate wasn't necessary to abate a great risk given that this is "the greatest public health danger this country has faced in the last century." Says OSHA's policy is "most geared" to stopping the pandemic and nothing would do better. /10 Kagan's questions are, essentially, whatever the statutory terms' outer limits are, how can COVID NOT be a public-health emergency warranting an emergency vaccine-mandate response? Best way to prevent harm is to get people vaccinated. /11 Kagan says the "agency has done everything except stand on its head" to show that a mandatory vaccination policy is the best way to prevent harm in the workplace. Keller says that States or individual workplaces can mandate vaccines, but not OSHA. /12 The Chief Justice, a key vote, asks Keller how "workplace" a hazard must be as opposed to "in the world" before OSHA can regulate it. Raises example of workers standing next to each other on an assembly line and asks whether OSHA can mandate vaccination. /13 Keller says that vaccination can't be mandated, but maybe barriers between workers can be. The Chief is unimpressed, saying that vaccination is clearly superior. /14 Chief says there is "some pressing urgency" to addressing the problem of COVID. Keller is on his heels, trying to bring it back to saying that this is an "economy-wide" mandate as opposed to an "industry-by-industry" response. /15 Keller throws the #CMS vaccine mandate challengers under the bus, suggesting that maybe a healthcare mandate might be justified, but not an economy-wide #OSHA mandate. /16 Justice Breyer is now talking, making several points, but noting that whether to grant an emergency stay is a different question than the overall merits and suggesting the discretion the Court has on a stay militates against granting one. /17 Breyer asks how it could "conceivably be in the public interest" given hospitalization rates to grant an emergency stay. A factor to consider in granting a stay is "where the public interest lies." Says it is "unbelievable" that a stay could be appropriate. /18 Safe to say that Justice Breyer is not voting for the challengers on the stay question. /19 We are now going justice-by-justice as we do at the end of each advocate's oral argument. Justice Gorsuch is up and he is asking about the "major questions doctrine" we've talked about on the blog. /20 Gorsuch is asking whether the major questions doctrine comes in only when the statute is ambiguous on its face. Keller says that it comes in even before a finding of ambiguity, but that the OSH Act is ambiguous. /21 Gorsuch also asks why a stay is appropriate. Keller argues that testing is unavailable to comply with the mandate and that workers will quit, throwing the economy into disarray, if the mandate is allowed to go into effect. /22 Justice Alito asks whether the question is whether the #OSHA mandate is necessary to protect the public or to protect unvaccinated workers who have chosen to be unvaccinated. Keller says the latter. /23 We're having audio issues on the livestream. It seems that people in the courtroom can hear Justice Sotomayor, but we can't. /24 We're back and Keller is speaking, but the context isn't clear. Keller is talking about 1-3% of workers will quit. We can hear Justice Sotomayor now, at least, who says that catching COVID keeps people out of the workplace. /25 I've only heard a few seconds of Justice Sotomayor going after Keller, but, yeah, you can put her in the Justice Breyer camp. She is not voting for a stay. /26 LOGISTICAL NOTE: I've argued at #SCOTUS by phone and their staff is top notch. That had to be the worst two minutes of their lives. They go above and beyond on these arguments. /27 Sotomayor asks how a vaccine mandate is different than telling workplaces "if sparks are flying, wear a mask." Keller argues the sparks are particular to the workplace whereas COVID is not. /28 Justice Kagan is up. Agrees that the question is "who decides" and says "respectfully, I think it has a different answer." So, yes, we have three votes against a stay. As expected. /29 Kagan emphasizes that agency is politically accountable through the President and has expertise and courts do not. Justice Kagan was a presidential-powers scholar before public service so this accountability theme is in her wheelhouse. /30 Justice Kavanaugh says he thinks the "who decides" question "gets to the heart of this." Says that critique of the major questions canon is how you decide a question is "major" enough. Asks Keller how court decides what is a "major" question. /31 Keller says number of workers covered, economic scope, and breadth all show that this is a "major" question. Also says this is a question of significant debate. /32 Kavanaugh asks what Court does if text is unambiguous but doesn't specifically speak to the question at issue. I'm not exactly sure what Keller's answer is. He seems to be saying just this law is difference. /33 Kavanaugh asks whether OSHA could issue a vaccine mandate through its general power as opposed to its emergency powers. Keller says no. /34 Justice Barrett says that Keller would be "hard pressed" to say that there aren't some workplaces where there is an increased risk from COVID than generally in the world, like meatpackers. Asks whether a more-targeted rule might be okay. /35 (She is asking Keller whether she thinks a more-targeted rule would be okay. She hasn't tipped her hand on whether she thinks this rule is too-broad.) Keller says a more-targeted rule might be okay, but this rule is far too broad. /36 Barrett says that "you're not disputing that if we're talking about healthcare workers" that OSHA could act. Suggests she might be in favor of the #CMS mandate coming next. And Keller keeps conceding away the CMS challengers' case. /37 Barrett asks whether Keller would contest a masking-and-testing regime. He says yes. She asks whether he would contest just a masking regime. He says yes. He says any economy-wide rule is improper. /38 Now Ben Flowers for Ohio is up. /39 Barrett's questions seem to suggest that she may think the #OSHA rule is too broad but a more-tailored rule may be okay. Also suggests that (as we talked on the blog) the Court may rule differently on the #OSHA and #CMS mandates. /40 Justice Thomas has the first question for Ben Flowers, who sounds like he is talking through a drive-thru microphone. Thomas asks if a danger in society can be so acute that it is brought into the workplace and can be regulated by presence there. /41 Flowers argues that OSHA can regulate only if the employer has done or failed to do something that creates the risk. Says that the risk of COVID is prevalent in the word, a restaurants and sporting events. Seems to also concede the meatpacking hypothetical. /42 Kagan asks whether there is any workplace that hasn't been transformed by COVID, except a few, like outdoors landscaping. Flowers says that workplaces have changed, but the risk isn't coming from the workplace and isn't a workplace risk. /43 Kagan pointing out that with leisure activities, you can decide whether to face the risk. But at work, you can't decide whether to face the risk with co-workers who may be unvaccinated and irresponsible. /44 Kagan and Flowers keep going back-and-forth whether the workplace is particularly risky. But she is a sure vote for the mandate. Breyer is now here, saying his "law clerks have been busy beavers" working on this case. /45 Breyer is back to saying that given the number of cases, he finds it "unbelievable" to say that stopping vaccinations is in the public interest. /46 Listing off pages from the Federal Register, Breyer emphasizes that OSHA considered the risk of employees quitting and weighed them and came out in favor of vaccinate-or-test. Why not defer to the agency's expertise in weighing that risk? /47 Keller got a lot of heat for his argument on social-media, but he so far has been more-effective than Flowers, who is being hampered by arguing by phone because of his positive COVID test. /48 Justice Sotomayor (which working audio!) confronts Flowers with hospitalization and case rates, asking why workplace rules are not necessary to prevent these harms. Says goal is to keep businesses running because sick workers can't work. /49 Sotomayor asks why States have power to mandate vaccines or testing but not OSHA. Flowers says that federal government has no police power. Sotomayor's rejoinder is that OSHA's constitutionality has been upheld. /50 Chief moves us to sequential questioning. Thomas asks Flowers to say how efficacious in preventing infection. Flowers emphasizes he is pro-vaccine, but that vaccines are not effective in preventing infection. Concedes, however, that COVID is serious. /51 Thomas asks whether Ohio could impose OSHA's rule. Flowers says that Ohio could impose vaccinations not just for workers, but all residents. Says that agencies and groups other than OSHA are trying to stop pandemic. /52 Thomas says stopping COVID is "not all or nothing," so OSHA mandate isn't only way to stop the pandemic. Breyer now asking whether OSHA can regulate fire. Flowers says yes, but that is workplace-specific hazard. /53 Alito asking Flowers whether OSHA is essentially protecting those who have said they don't want to be protected by not being vaccinated. Flowers says that's right. /54 Sotomayor follows up on that, saying it's not just the risk to unvaccinated people, but the risk that the unvaccinated pose to the vaccinated. Flowers says that OSHA has conceded that the vaccinated are not at risk and it has to be consistent with itself. /55 Justice Kagan takes issues with Justice Alito's framing, saying that just because someone doesn't want to be protected doesn't mean that OSHA can't protect them anyway. /56 Justice Gorsuch comes back to "who decides." Sees it that States have broad police powers, Congress has certain powers, and agencies do what Congress tells them to do. Says major-questions doctrine sorts through this and suggests agency doesn't have this power. /57 Flowers says major-questions can be "constitutional avoidance" doctrine, coming into play when an agency that claims powers that allow it to regulate "coast to coast." Pretty much argues that Congress doesn't have power to require vaccination or testing, either. /58 Kavanaugh asks Flowers to explain the value of Congress giving express powers to regulate in the midst of an emergency. Justice Kavanaugh suggesting that he might join position that Congress has to be the one to authorize vaccine mandate. /59 U.S. Solicitor General Elizabeth Prelogar, who, full disclosure, is a former colleague of mine, is now up. Argues that vaccine or test is "highly effective" to "stop this deadly disease at work." /60 Thomas asks Prelogar whether the problem OSHA is regulating is the problem of the employer not requiring vaccination or testing or the employees not vaccinating or testing. Prelogar says it is about addressing the "grave danger" by requiring employers to target danger. /61 Thomas asks whether argument is the same for any infectious disease, or whether COVID is unique. Prelogar says it depends on the facts. If standard is met, then yes, OSHA can regulate, such as blood-borne pathogens. /62 Chief Justice says that government is saying COVID is a "grave danger" under all of its statutory authorities. Says that this isn't a OSHA-specific regulation, or CMS-specific regulation, or contractor-specific regulation, but rather a "workaround" for mass vaccination. /63 Prelogar turns it around, saying that just because CVOID is a danger everywhere doesn't mean OSHA's powers are less. Roberts replies that this should be viewed as an attempt to "cover the waterfront" and a general attempt to regulate that lies with Congress and the States. /64 The Chief's questions to Prelogar seem to focus on the issue of over-breadth, worried that OSHA is not issuing workplace regulations, but is rather one part of a broad attempt to vaccinate all Americans. Roberts says that broad attempt should come from Congress and States. /65 Dispute between Prelogar and Roberts is that Prelogar wants to look at each statute and regulation one-by-one. Roberts wants to view all agency actions taken together. /66 So far, things aren't looking good for supporters of the current broad #OSHA vaccine-or-test regulation. Median justices, however, may endorse a targeted regulation aimed at specific higher-risk workplaces. /67 Key question I am now going to be following as we go into the next argument is whether median justices see healthcare workers as a particular, targeted high-risk environment or not. /68 Prelogar is arguing, in response to Breyer, that OSHA mandate is broad, but it's broad BECAUSE COVID is dangerous wherever people gather, and that is any workplace. In some places, risk may be more grave, but it is grave everywhere. /69 Alito asks whether Court should issue brief administrative stay to enjoin OSHA enforcement while Court decides whether to permanently stay the OSHA mandate. /70 Prelogar concedes that Court should do that if it feels it needs to, but says it should be brief. Roberts asks "brief compared to what?" and notes months of non-enforcement so far. /71 Breyer now comes in, re-emphasizing his theme that every day the Court enjoins enforcement means more cases and more hospitalizations. /72 Sotomayor also argues against an administrative stay, saying that risk of mass resignation arises only in February. Prelogar says that one is not necessary but she defers to the Court. /73 (Sotomayor accidently calls Justice Gorsuch "Neil" before correcting herself.) /74 Prelogar arguing that the OSH Act is sufficiently clear to support a vaccine-or-test mandate. Roberts expresses doubt that Congress, in 1970, had COVID in mind. Emphasizes that OSHA has never directed vaccines before. /75 Roberts says that this is akin to OSHA exercising a general police power reserved to the States and that, under the major-questions doctrine, we should be looking for a clearer Congressional authorization. /76 If you are a supporter of the #OSHA mandate as it currently exists, it is hard to count to five votes in favor. It sounds like at least two of Roberts, Kavanaugh, and Barrett think it is too broad and intrudes too much on the police power. /77 Alito leads in to a question saying that he is not saying the vaccines or unsafe and "he doesn't want to be misunderstood" but asks whether vaccines have some risk. Prelogar says yes, but benefits outweigh risks by "orders of magnitude." Alito agrees. But says there is risk. /78 Kagan jumps in to say that regulators weigh one set of risks against another all the time and routinely subject regulated to one set of risks to prevent another, greater risk. /79 Alito is essentially arguing that if the unvaccinated want to take the risk, why shouldn't OSHA let them? /80 Alito also asks about testing capacity, asking whether there is enough capacity for mask-and-test employers. Prelogar says OSHA considered that and could adjust if circumstances changed. /81 Kagan raises question about how to view the major-questions doctrine. Does it merely resolve ambiguity? Or can it be used to narrow broad, but unambiguous, text? Prelogar says the former. /82 Coming back to "who decides?", Gorsuch says that courts do not decide health policy, but it does decide whether agencies or States and Congress decide on vaccine mandates. Endorses "workaround" argument from Chief. /83 Prelogar argues that the OSH Act rejects the notion that the federal government needs to leave workplace safety up to the States. Gorsuch asks why not require flu vaccines or polio vaccines? /84 Prelogar says workers are already vaccinated against polio. Gorsuch pivots to flu. Prelogar says OSHA could, if the country experienced a sufficiently severe flu outbreak. /85 Kavanaugh says that major-questions doctrine applies not just when a text is ambiguous, but also when it is cryptic or oblique. Suggests that OSHA's powers are sufficiently cryptic or oblique. /86 Prelogar says in past major-questions cases, there were contextual clues that made the text ambiguous. Says all contextual clues weigh in favor of mandate here. /87 Kavanaugh says that statutes have expressly referred to vaccines in other contests, but not OSHA. Says Pres. Bush foresaw a future pandemic, but still Congress hasn't acted, even though it could have. /88 The key dispute here is between those who think that a broad, general authorization is enough and those who think that unprecedented powers need specific authorization. /89 Barrett asks about mandate's status as an emergency standard. Says ETS should be exception, not rule. Points to difference between OSHA general power and emergency power. Says "necessary" for ETS requires more tailoring. /90 Prelogar concedes that there may be workers in "graver" danger, but that all workers are in grave danger. /91 Barrett invokes Chief Justice Sutton's dissent in the Sixth Circuit, asking when the "emergency" ends and OSHA must rely on notice-and-comment process. /92 Prelogar notes that agency can only keep ETS in place in six months. Barrett agrees, but asks about other ETS's as pandemic evolves. /93 Now Keller is up for rebuttal for the challengers. Argues a stay is needed now before the first compliance deadline Monday. Also argues that lack of clear mandate means OSHA does not have power and public interest lies in enforcing limits on agencies. /94 And that is it. The applications are submitted. We will reconvene for the CMS mandate arguments shortly in a new thread. My bottom line? I am expecting the OSHA mandate to be enjoined as too broad and not clearly authorized. /Fin </div> <div class="col-md-4"> <h3><a href="/news/blog/2021-12-01-blog-updates-legal-challenges-cms-vaccine-mandate-rule">Blog: Updates on Legal Challenges to CMS and OSHA Vaccine Mandate Rule</a></h3> <hr /> <div> <h3 class="text-align-center">Advancing Health Podcast: Analysis of Supreme Court Oral Arguments on Vaccine Mandates</h3> <div><a href="https://soundcloud.com/advancinghealth" target="_blank" title="Advancing Health">Advancing Health</a> · <a href="https://soundcloud.com/advancinghealth/analysis-of-supreme-court-oral-arguments-on-vaccine-mandates" target="_blank" title="Analysis of Supreme Court Oral Arguments on Vaccine Mandates">Analysis of Supreme Court Oral Arguments on Vaccine Mandates</a></div> </div> </div> </div> </div> Fri, 07 Jan 2022 08:00:00 -0600 Legal Supreme Court Cases /supreme-court-cases .leadp p { size: 16px; font-size: 16px; } <div class="container"> <div class="row"> <div class="col-md-8"> <h2>ACA Individual Mandate (Texas v. California)</h2> <div class="leadp"> The Supreme Court of the United States on November 10, 2020, will hear&nbsp;oral arguments in the case of California v. Texas, in which those opposed to the Affordable Care Act contend that when Congress set the tax penalty for failing to purchase insurance at zero dollars, the ACA’s requirement that most Americans obtain health insurance became unconstitutional. <hr /> <div><a href="https://soundcloud.com/advancinghealth" target="_blank" title="Advancing Health">Advancing Health</a> · <a href="https://soundcloud.com/advancinghealth/supreme-court-hears-oral-argument-in-appeal-of-aca-ruling" target="_blank" title="Supreme Court hears oral argument in appeal of ACA ruling">Supreme Court hears oral argument in appeal of ACA ruling</a></div> <hr /> <h3><a href="/news/blog/2020-11-05-blog-5-things-listen-during-next-weeks-supreme-court-aca-oral-argument" target="_blank">Blog: 5 Things to Listen for During the Nov. 10 Supreme Court ACA Oral Argument</a></h3> In this <a href="/news/blog/2020-11-05-blog-5-things-listen-during-next-weeks-supreme-court-aca-oral-argument" target="_blank">AHA blog post</a>, Sean Marotta, AHA outside counsel, shares five things to look for when the Supreme Court hears oral argument Nov. 10 in the latest challenge to the Affordable Care Act. Marotta authored AHA’s friend-of-the-court brief in the case, and will be live tweeting the oral argument and providing analysis for AHA at <a href="https://twitter.com/smmarotta" target="_blank">@smmarotta</a> and here on the AHA website starting at 10 a.m. ET. </div> <div class="row"> <div class="col-md-6"><div class="views-element-container"> <section class="top-level-view js-view-dom-id-4555f644aed497e24d6ccb1376c9d71877294e2b16b72d69d9cdd85a98e9315f resource-block"> <h2>Legal Filings</h2> <div class="resource-wrapper"> <div class="resource-view"> <div class="article views-row"> <div class="views-field views-field-title"> <a href="/supreme-court-cases" hreflang="en">Supreme Court Cases</a> </div><div class="views-field views-field-created"> <time datetime="2020-11-04T16:24:58-06:00">Nov 4, 2020</time> </div></div> <div class="article views-row"> <div class="views-field views-field-title"> <a href="/amicus-brief/2020-05-13-amicus-brief-36-state-hospital-associations-support-petitioners" hreflang="en">Amicus Brief: 36 State Hospital Associations in Support of Petitioners</a> </div><div class="views-field views-field-created"> <time datetime="2020-05-13T14:44:53-05:00">May 13, 2020</time> </div></div> <div class="article views-row"> <div class="views-field views-field-title"> <a href="/amicus-brief/2020-05-13-amicus-brief-national-hospital-associations-support-california-state" hreflang="en">Amicus Brief: National Hospital Associations in Support of the California State Coalition and House of Representatives</a> </div><div class="views-field views-field-created"> <time datetime="2020-05-13T14:29:01-05:00">May 13, 2020</time> </div></div> <div class="article views-row"> <div class="views-field views-field-title"> <a href="/amicus-brief/2020-01-16-amicus-brief-state-hospital-groups-urge-supreme-court-review-aca-case-term" hreflang="en">Amicus Brief: State Hospital Groups Urge Supreme Court to Review ACA Case this Term</a> </div><div class="views-field views-field-created"> <time datetime="2020-01-16T14:08:24-06:00">Jan 16, 2020</time> </div></div> <div class="article views-row"> <div class="views-field views-field-title"> <a href="/amicus-brief/2020-01-15-amici-curiae-brief-aha-and-national-hospital-associations-support" hreflang="en">Amici Curiae Brief of the AHA and National Hospital Associations in Support of the Petitioners </a> </div><div class="views-field views-field-created"> <time datetime="2020-01-15T13:38:02-06:00">Jan 15, 2020</time> </div></div> </div> </div> </section> </div> <div class="views-element-container"> <section class="top-level-view js-view-dom-id-61fc2d7740de19d04eda004a801c94facaff30844b99c7032943cafd2b18bd39 resource-block"> <h2>Special Bulletins</h2> <div class="resource-wrapper"> <div class="resource-view"> <div class="article views-row"> <div class="views-field views-field-title"> <a href="/special-bulletin/2020-09-21-aha-video-how-us-supreme-court-vacancy-could-affect-health-care-cases-0" hreflang="en">Special Bulletin: AHA Video — How the U.S. Supreme Court Vacancy Could Affect Health Care Cases</a> </div><div class="views-field views-field-created"> <time datetime="2020-09-21T18:18:40-05:00">Sep 21, 2020</time> </div></div> <div class="article views-row"> <div class="views-field views-field-title"> <a href="/special-bulletin/2019-12-19-special-bulletin-appeals-court-finds-aca-individual-mandate" hreflang="en">Special Bulletin: Appeals Court Finds ACA Individual Mandate Unconstitutional </a> </div><div class="views-field views-field-created"> <time datetime="2019-12-19T14:54:45-06:00">Dec 19, 2019</time> </div></div> </div> </div> </section> </div> <div class="views-element-container"> <section class="top-level-view js-view-dom-id-274520329e0c8b820d660011548ff5ad0c9dff68927461882c41f8fb2d775c92 resource-block"> <h2>Press Releases and Statements</h2> <div class="resource-wrapper"> <div class="resource-view"> <div class="article views-row"> <div class="views-field views-field-title"> <a href="/news/blog/2021-06-17-blog-affordable-care-act-survives-third-supreme-court-suit-unscathed" hreflang="en">Blog: Affordable Care Act Survives Third Supreme Court Suit Unscathed</a> </div><div class="views-field views-field-created"> <time datetime="2021-06-17T14:12:47-05:00">Jun 17, 2021</time> </div></div> <div class="article views-row"> <div class="views-field views-field-title"> <a href="/press-releases/2021-06-17-statement-supreme-court-decision-affordable-care-act" hreflang="en">STATEMENT ON SUPREME COURT DECISION ON THE AFFORDABLE CARE ACT</a> </div><div class="views-field views-field-created"> <time datetime="2021-06-17T09:42:25-05:00">Jun 17, 2021</time> </div></div> <div class="article views-row"> <div class="views-field views-field-title"> <a href="/press-releases/2020-03-02-statement-supreme-court-decision-california-v-texas" hreflang="en">Statement on Supreme Court decision in California v. Texas</a> </div><div class="views-field views-field-created"> <time datetime="2020-03-02T09:51:09-06:00">Mar 2, 2020</time> </div></div> <div class="article views-row"> <div class="views-field views-field-title"> <a href="/news/blog/2019-12-19-key-takeaways-and-next-steps-aca-court-case" hreflang="en">Key takeaways and next steps in ACA court case</a> </div><div class="views-field views-field-created"> <time datetime="2019-12-19T15:53:16-06:00">Dec 19, 2019</time> </div></div> <div class="article views-row"> <div class="views-field views-field-title"> <a href="/press-releases/2019-12-19-statement-fifth-circuit-court-appeals-decision-affordable-care-act" hreflang="en">Statement on Fifth Circuit Court of Appeals Decision on the Affordable Care Act</a> </div><div class="views-field views-field-created"> <time datetime="2019-12-19T09:18:57-06:00">Dec 19, 2019</time> </div></div> </div> </div> </section> </div> </div> <div class="col-md-6"><div class="views-element-container"> <section class="top-level-view js-view-dom-id-e6d2370ea697ccd893f02f5c60e9d6578c4d08ac5816f6027c9641a50edfd0d5 resource-block"> <h2>News</h2> <div class="resource-wrapper"> <div class="resource-view"> <div class="article views-row"> <div class="views-field views-field-title"> <a href="/news/blog/2021-06-17-blog-affordable-care-act-survives-third-supreme-court-suit-unscathed" hreflang="en">Blog: Affordable Care Act Survives Third Supreme Court Suit Unscathed</a> </div><div class="views-field views-field-created"> <time datetime="2021-06-17T14:12:47-05:00">Jun 17, 2021</time> </div></div> <div class="article views-row"> <div class="views-field views-field-title"> <a href="/news/headline/2021-06-17-supreme-court-dismisses-third-major-challenge-aca-see-ahas-media-statement" hreflang="en">Supreme Court dismisses third major challenge to ACA; see AHA’s media statement and blog for more analysis</a> </div><div class="views-field views-field-created"> <time datetime="2021-06-17T13:05:22-05:00">Jun 17, 2021</time> </div></div> <div class="article views-row"> <div class="views-field views-field-title"> <a href="/news/headline/2020-09-22-aha-video-how-us-supreme-court-vacancy-could-affect-health-care-cases" hreflang="en">AHA video: How the U.S. Supreme Court vacancy could affect health care cases</a> </div><div class="views-field views-field-created"> <time datetime="2020-09-22T14:38:59-05:00">Sep 22, 2020</time> </div></div> <div class="article views-row"> <div class="views-field views-field-title"> <a href="/news/headline/2020-06-26-trump-administration-asks-supreme-court-strike-down-aca" hreflang="en">Trump administration asks Supreme Court to strike down ACA</a> </div><div class="views-field views-field-created"> <time datetime="2020-06-26T14:20:50-05:00">Jun 26, 2020</time> </div></div> <div class="article views-row"> <div class="views-field views-field-title"> <a href="/news/headline/2020-06-26-nearly-487000-enroll-healthcaregov-coverage-april" hreflang="en">Nearly 487,000 enroll in HealthCare.gov coverage in April</a> </div><div class="views-field views-field-created"> <time datetime="2020-06-26T14:20:47-05:00">Jun 26, 2020</time> </div></div> <div class="article views-row"> <div class="views-field views-field-title"> <a href="/news/headline/2020-05-13-supreme-court-urged-reverse-appeals-court-ruling-aca" hreflang="en">Supreme Court urged to reverse appeals court ruling on ACA</a> </div><div class="views-field views-field-created"> <time datetime="2020-05-13T15:38:01-05:00">May 13, 2020</time> </div></div> <div class="article views-row"> <div class="views-field views-field-title"> <a href="/news/headline/2020-03-02-supreme-court-will-review-aca-case" hreflang="en">Supreme Court will review ACA case</a> </div><div class="views-field views-field-created"> <time datetime="2020-03-02T14:01:09-06:00">Mar 2, 2020</time> </div></div> <div class="article views-row"> <div class="views-field views-field-title"> <a href="/news/headline/2020-01-21-supreme-court-will-not-expedite-review-aca-case" hreflang="en">Supreme Court will not expedite review of ACA case </a> </div><div class="views-field views-field-created"> <time datetime="2020-01-21T14:46:57-06:00">Jan 21, 2020</time> </div></div> <div class="article views-row"> <div class="views-field views-field-title"> <a href="/news/headline/2020-01-16-state-hospital-groups-urge-supreme-court-review-aca-case-term" hreflang="en">State hospital groups urge Supreme Court to review ACA case this term </a> </div><div class="views-field views-field-created"> <time datetime="2020-01-16T16:16:32-06:00">Jan 16, 2020</time> </div></div> <div class="article views-row"> <div class="views-field views-field-title"> <a href="/news/headline/2020-01-15-national-hospital-groups-urge-supreme-court-review-aca-case-term" hreflang="en">National hospital groups urge Supreme Court to review ACA case this term</a> </div><div class="views-field views-field-created"> <time datetime="2020-01-15T15:04:33-06:00">Jan 15, 2020</time> </div></div> </div> </div> </section> </div> </div> </div> </div> <div class="col-md-4"> <h3><a href="https://twitter.com/smmarotta/status/1326208952351268869" target="_blank">See Sean Marotta's full thread of Tweets on the SCOTUS oral arguments in the ACA Individual Mandate&nbsp;Case on Twitter.</a></h3> <hr /> <h4><a href="https://threadreaderapp.com/thread/1326176638581805058.html" target="_blank">You can also view the thread through the Threader Reader App.</a></h4> </div> </div> </div> Wed, 04 Nov 2020 16:24:58 -0600 Legal Court Sets Briefing Schedule on Our Motion to Enforce the Court's Judgment in the Case (Nov. 12, 2019) /legal/2019-11-12-court-sets-briefing-schedule-our-motion-enforce-courts-judgment-case-nov-12-2019 Tue, 12 Nov 2019 12:38:32 -0600 Legal Steps Hospitals Can Take to Preserve Their Right to Seek Full Reimbursement Amounts under the 2017 Rate Thu, 29 Mar 2018 12:25:34 -0500 Legal Past Litigation /legal/past-litigation <hr /> <h2>340B Delayed Regulations on Transparency and CMPs</h2> <ul> </ul> <a href="/system/files/media/file/2019/04/stipulation-of-dismissal-by-340B-Health-et-al-0037-2019-04-25.pdf">Stipulation of Dismissal</a>, April 25, 2019 <a href="/system/files/media/file/2019/04/0036-2019-04-25-joint-status-report-stipulation-of-dismissal.pdf">Joint Status Report and Stipulation of Dismissal</a>, April 25, 2019 <a href="/system/files/media/file/2019/04/340b-2019-04-04-minute-order-ordering-parties-to-file-joint-status-report.pdf">Minute Order Ordering Parties to File Joint Status Report</a> (April 3, 2019) <a href="/system/files/media/file/2019/04/340b-2019-04-03-governments-status-report.pdf">Defendant's Status Report</a>&nbsp;(April 3, 2019) <ul> <li><a href="/system/files/media/file/2019/04/340b-2019-04-03-declaration-of-krista-pedley.pdf">Declaration of Krista Pedley</a> (April 3, 2019)</li> </ul> <a href="/system/files/media/file/2019/03/Judge-Bates-minute-order-vacating-march-15-status-conference-ordering-pricing-publication-status-report.pdf">Minute Order Vacating Status Conference and Order that Defendants file Status Report</a>&nbsp;(March 14, 2019) <a href="/system/files/2019-02/2019-02-28_HHS-Status-Report.pdf">Status Report</a> (February 28, 2019) <ul> <li><a href="/system/files/2019-02/2019-02-28_HHS-Declaration.pdf">Declaration of Krista Pedley</a> (February 28, 2019)</li> </ul> <a href="/system/files/media/file/2019/03/340b-motion-to-cancel-march152019-conference-require-defendants-to-file-status-report.pdf">Joint Motion to Cancel Status Conference and Require Defendants to File a Status Report</a>&nbsp;(March 14, 2019) <ul> <li><a href="/system/files/media/file/2019/03/340B-03142019-proposed-order.pdf">Proposed Order</a>&nbsp;(March 14, 2019)</li> </ul> <a href="/system/files/2018-12/0029-01-2018-12-20-amended-complaint.pdf">Amended complaint</a> (December 20, 2018) <a href="/legal-documents/2018-12-18-court-order-status-reports-and-amendment-complaint-dec-12-2018">Court Order for Status Reports and Amendment of Complaint</a> (December 12, 2018) <a href="/system/files/2018-12/181203-defendants-reply-support-motion-to-dismiss.pdf">Defendant's Reply in Support of Motion to Dismiss for Lack of Jurisdiction</a> (December 3, 2018) <ul> <li><a href="/system/files/2018-12/181203-exhibit-1-pedley-declaration.pdf">Exhibit 1 - Declaration of Krista Pedley</a> (December 3, 2018)</li> </ul> <a href="/system/files/2018-11/181121-memorandum-opposition-def-dismiss.pdf">Memorandum in Opposition to Defendants' Motion to Dismiss and Reply in Support of Summary Judgment</a> (November 21, 2018) <a href="/system/files/2018-11/181113-340b-delay-govt-memo-opposition-summary-judgment.pdf">Government’s memorandum, in opposition to our motion for summary judgment and in support of their motion to dismiss</a> (November 13, 2018) <a href="/system/files/2018-11/181107-joint-proposed-schedule-340b-delay.pdf">Briefing schedule proposed order</a> (November 7, 2018) <a href="/system/files/2018-11/181102-order-denying-motion-stay.pdf">Order denying the Government's motion to stay</a> (November 2, 2018) <a href="/system/files/2018-11/181031-defendants-notice-pub-nprm.pdf">Government's notice related to Notice of Proposed Rulemaking</a> (October 31, 2018) <a href="/system/files/2018-10/2018-10-25-reply-to-opposition-to-motion-re-15-motion-to-stay.pdf">Reply to Opposition to Motion for a Stay</a> (October 25, 2018) <a href="/system/files/2018-10/181018-opposition-to-motion-to-stay.pdf">Opposition to Motion for a Stay</a> (October 18, 2018) <a href="/system/files/2018-10/181015-motion-for-stay-340b.pdf">HHS Motion for A Stay </a>(October 15, 2018) <a href="/legal-documents/2018-09-11-hospital-groups-sue-hhs-seeking-340b-price-transparency-now">Hospital groups sue HHS seeking 340B price transparency now</a> (September 11, 2018) <h2>&nbsp;</h2> <h2>&nbsp;</h2> <h2>AHA, Hospitals Sue to Require HHS to Meet Deadlines for Deciding Appeals</h2> <a href="/news/headline/2018-11-01-court-rules-aha-medicare-appeals-backlog-case">Court rules for AHA in Medicare appeals backlog case</a> (Nov. 1, 2018) <ul> <li><a href="/system/files/2018-11/181101-aljdelay-remedyopinion.pdf">Remedial Opinion</a></li> <li><a href="/system/files/2018-11/181101-aljdelay-remedyorder.pdf">Remedy Order</a></li> </ul> <a href="/system/files/2018-08/AHA-v-Azar-Plaintiffs-Remedies-Reply-With-ECF-Stamp.pdf">AHA, Hospitals reply to Government’s response to recommended non-deadline remedies</a> (Aug. 10, 2018) <a href="/legal-documents/2018-08-06-secretarys-remedy-response-brief">Government's Response to the Remedies Response</a> (Aug. 3, 2018) <ul> <li><a href="/system/files/2018-08/180803-ahavazar-secy-remedy-brief.pdf">Secretary's Remedy Brief</a></li> <li><a href="/system/files/2018-08/180803-ahavazar-griswold-remedy-declaration.pdf">Griswold Remedy Declaration</a> <ul> <li><a href="/system/files/2018-08/180803-ahavazar-griswold-remedy-declaration-exh-a.pdf">Griswold Remedy Declaration Exhibit A</a></li> <li><a href="/system/files/2018-08/180803-ahavazar-griswold-remedy-declaration-exh-b.pdf">Griswold Remedy Declaration Exhibit B</a></li> </ul> </li> <li><a href="/system/files/2018-08/180803-ahavazar-mills-remedy-declaration.pdf">Mills Remedy Declaration</a></li> <li><a href="/system/files/2018-08/180803-ahavazar-mcqueen-remedy-declaration.pdf">McQueen Remedy Declaration</a></li> <li><a href="/system/files/2018-08/180803-ahavazar-cochran-remedy-declaration.pdf">Cochran Remedy Declaration</a></li> <li><a href="/system/files/2018-08/180803-ahavazar-iwugo-remedy-declaration.pdf">Iwugo Remedy Declaration</a></li> </ul> <a href="/system/files/2018-07/180719-alj-delay-courts-grants-ext.pdf">The Court grants govt until Aug 3 to respond to AHA, Hospitals remedies brief</a> (July 19, 2018) <a href="/system/files/2018-07/180711-notice-electronic-filing-extension-request.pdf">Government does not get anywhere as much time for its reply as they requested</a> (July 11, 2018)&nbsp; <a href="/system/files/2018-07/180702-hospitals-oppose-sec-motion-for-extension.pdf">AHA, Hospitals Oppose the Secretary Motion for Extension of Time to Reply</a> (July 5, 2018) <ul> <li><a href="/system/files/2018-07/180702-govt-extension-motion.pdf">Government's motion for extension</a></li> </ul> <a href="/system/files/2018-06/180622-aha-azar-plaintiff-opening-brief.pdf">AHA, Hospitals brief outlining non-deadline remedies to address appeals backlog</a> (June 22, 2018) <ul> <li><a href="/system/files/2018-06/180622-aha-azar-plaintiffs-remedy-proposed-order.pdf">Proposed Remedial Order</a></li> </ul> <a href="/legal-documents/2018-03-22-court-order-alj-delay-case-march-22-2018">Court Order</a> (March 22, 2018) <a href="/system/files/2018-03/180227-court-date-alj-delay.pdf">Court Sets Hearing Date for ALJ Delay Mandamus Remand</a> (February 27, 2018) <a href="/legal-documents/2018-02-15-reply-brief-aha-hospitals-alj-backlog-mandamus-order">AHA's and Hospitals' Reply Brief: Reinstate HHS Deadline to Clear Appeals Backlog</a> (February 15, 2018) <a href="/system/files/2018-02/AHAvAzar-SecyOpptoMSJ.pdf">Government’s Brief in Support of its Motion for Summary Judgment/in Opposition to AHA, Hospitals’ Motion for Summary Judgment</a> (February 1, 2018) <ul> <li><a href="/system/files/2018-02/AHAvAzar-GriswoldSuppDecl.pdf">Nancy Griswold's Supporting Declaration</a></li> <li><a href="/system/files/2018-02/AHAvAzar-SecyUpdatedWorkloadProjections.pdf">Medicare Appeals Updated Workload Projections</a></li> </ul> <a href="/system/files/content/17/aha-vs-hargan.pdf" target="_blank">AHA's and Hospitals' Reply Brief on Mandamus Remand</a> (December 20, 2017) <a href="/system/files/2018-02/171122-AHAvHargan-MillsProgramIntegrityDeclaration.pdf">Declaration of George Mills, Deputy Director of the Center for Program Integrity (CPI), CMS</a> (November 22, 2017) <a href="/system/files/2018-02/171103-AHAvHargan-MSJ.pdf">Government's Motion for Summary Judgment in the ALJ Mandamus Remand</a> (November 3, 2017) <ul> <li><a href="/system/files/2018-02/171103-AHAvHargan-MSJBagelDecl.pdf">Declaration of Michael R. Bagel</a></li> <li><a href="/system/files/2018-02/171103-AHAvHargan-MSJGriswoldDecl.pdf">Declaration of Nancy J. Griswold</a></li> <li><a href="/system/files/2018-02/171103-AHAvHargan-MSJMcQueenDecl.pdf">Declaration of Sherri McQueen</a></li> <li><a href="/system/files/2018-02/171103-AHAvHargan-MSJMillsDecl.pdf">Declaration of George G. Mills</a></li> <li><a href="/system/files/2018-02/171103-AHAvHargan-MSJMemoofLaw.pdf">Memorandum of Points and Authorities in Support of Defendant's Motion for Summary Judgment</a></li> <li><a href="/system/files/2018-02/171103-AHAvHargan-MSJStatementofFacts.pdf">Defendant's Statement of Facts</a></li> </ul> <a href="/system/files/2018-03/171025-extension-granted.pdf">Court Grants In Part Govt’s Request for Additional Time</a> (October 25, 2017) <a href="/system/files/2018-02/171023-AHAvHargan-PartialExtOpp.pdf">AHA, Hospitals Oppose Request of Govt. for Additional Time to File</a> (October 23, 2017) <a href="/system/files/2018-02/AHAvPrice-HHSExtensionMotion.pdf">Government Requests Extension of Time to File Its Motion for Summary Judgment </a>(October 19, 2017) <a href="/system/files/2018-02/170928-AHAvPrice-OrderGoverningFurtherProceedings.pdf">Trial Court Sets Briefing Schedule in ALJ Mandamus Remand</a> (September 28, 2017) <a href="/system/files/2018-03/170914-court-order-granting-motion-for-immediate-issuance.pdf">Appeals Court grants AHA, Hospitals Request for Immediate Issuance of Mandate of Remand</a> (September 14, 2017) <ul> <li><a href="/system/files/2018-03/170914-issuance-of-mandate-immediate-remand-to-trial-court.pdf">Issuance of the Mandate of Immediate Remand to the Trial Court</a></li> </ul> <a href="/system/files/2018-02/AHAvPrice-MandateMotion.pdf">AHA, Hospitals Unopposed Motion to Issue Mandate for Case Remand Without Delay</a> (September 11, 2017) <a href="/legal/litigation-aha-hospitals-sue-require-hhs-meet-deadlines-deciding-appeals">Read more on this topic</a> <hr /> <h2>AHA, Hospital Associations, Hospitals Sue HHS Over Two-midnight Inpatient Admissions Rule</h2> <h2>Two-Midnights and Other Requirements Complaint</h2> <a href="/system/files/media/file/2023/01/governments-responsive-supplemental-brief-re-two-midnight-rule-feb-29-2016.pdf" target="_blank">Government’s responsive supplemental brief</a><a href="/content/16/160229-2midsgovresp.pdf">,</a> February 29, 2016 <a href="/system/files/media/file/2023/01/aha-associations-hospitals-supplemental-as-filed-brief-re-2-midnight-rule-2-1-2016.pdf">AHA, associations, hospitals supplemental brief</a>, February 1, 2016 <ul> <li><a href="/system/files/content/16/160201AsFiledDeclAnnBrunner.pdf">Declaration for Einstein Healthcare Network (Brunner)</a></li> <li><a href="/system/files/content/16/160201AsFiledDeclLukeHermann.pdf" target="_blank">Declaration for The Mount Sinai Hospital (Hermann)</a></li> <li><a href="/system/files/content/16/160201AsFiledDeclLeslieMorgan.pdf" target="_blank">Declaration for Banner Health (Morgan)</a></li> </ul> <a href="/system/files/media/file/2023/01/aha-associations-hospitals-response-to-supplemental-authority-letter-2-midnight-10-22-2014.pdf">AHA, Associations, Hospitals’ response to supplemental authority letter</a>, October 22, 2014 <a href="/system/files/media/file/2023/01/governments-supplemental-authority-letter-re-two-midnights-and-other-requirements-complaint-letter-10-20-2014.pdf">Government's supplemental authority letter</a>, October 20, 2014 <a href="/system/files/media/file/2023/01/court-decides-to-consider-governments-motion-to-dismiss-2-midnight-letter-10-14-2014.pdf" target="_blank">Court decides to consider government’s motion to dismiss first</a>, October 14, 2014 <a href="/system/files/media/file/2023/01/governments-brief-supporting-its-motion-to-dismiss-two-midnights-litigation-letter-9-4-2014.pdf">Government's&nbsp;brief supporting its motion to dismiss two-midnights litigation</a>, September 4, 2014 <a href="/system/files/media/file/2023/01/aha-associations-hospitals-oppose-governments-motion-to-stay-summary-judgment-briefing-re-two-midnight-8-18-2014.pdf" target="_blank">AHA, Associations, Hospitals Oppose Government’s Motion to Stay Summary Judgment Briefing</a>, August 18, 2014 <a href="/content/14/140815govtmotionstay2midnight.pdf">Government’s Motion - Court should stay request for summary judgment to consider Government’s&nbsp; motion to dismiss first</a>, August 15, 2014 Court grants government extension of time to file reply to support its motion to dismiss complaint, August 11, 2014 Docket Text: Set/Reset Deadline: The defendant shall file her reply in support of her motion to dismiss on or before 9/4/2014. (ad) <a href="/content/14/140804reqsummjudg-2midnight.pdf">AHA, Hospital Associations, Hospitals Request Summary Judgment, Oppose Government’s Motion to Dismiss 2-Midnight Complaint</a>, August 4, 2014 <ul> <li><a href="/content/14/140804proporder.pdf">Proposed Order</a></li> </ul> <a href="/content/14/140716-motiontodismiss-2midnight.pdf">Government moves to dismiss AHA, Associations, Hospitals’ 2-midnights complaint</a>, July 16, 2014 <a href="/content/14/140414-complaint-2midnight.pdf">AHA, Hospital Associations, Hospitals Complaint Regarding Two-midnight Rule</a>, April 14, 2014 <h2>0.2 Percent Offset Complaint</h2> <a href="https://ifdhe.aha.org/sites/default/files/aha-comments-on-cmss-dec-1-2015-notice-about-02-percent-reduction-to-hospital-ipps-payments.pdf">AHA comments on CMS's Dec. 1, 2015 Notice about 0.2 percent reduction to Hospital IPPS payments</a>, February 2, 2016 <a href="/system/files/media/file/2023/01/court-orders-remand-for-the-point-2-percent-payment-offset-related-to-the-2-midnight-policy-shands-9-21-2015.pdf" target="_blank">Court orders remand for the .2% payment offset related to the 2-midnight policy</a>, September 21, 2015 <a href="/system/files/media/file/2023/01/aha-athens-regional-and-bakersfield-heart-plaintiffs-proposed-reply-supporting-vacatur-8-31-23.pdf" target="_blank">AHA,&nbsp;Athens Regional and Bakersfield Heart Plaintiffs' Proposed Reply Supporting Vacatur</a>, August 31, 2015 <ul> <li><a href="/system/files/media/file/2023/01/related-motion-for-leave-to-file-two-reply-briefs-8-31-2015.pdf" target="_blank">Related Motion for Leave to File Two Reply Briefs</a> (Aug. 31, 2015) - Court Granted Motion Sept. 1, 2015</li> <li><a href="/system/files/media/file/2023/01/related-proposed-order-re-motion-for-leave-to-file-8-31-2015.pdf" target="_blank">Related Proposed Order re Motion for Leave to File</a> (Aug. 31, 2015)</li> </ul> <a href="/system/files/media/file/2023/01/shands-jacksonville-st-helena-plaintiffs-proposed-reply-supporting-vacatur-8-31-2015.pdf" target="_blank">Shands Jacksonville, St. Helena Plaintiffs’ Proposed Reply Supporting Vacatur</a>, August 31, 2015 <a href="/system/files/media/file/2023/01/hhs-governments-reply-opposing-vacatur-8-31-2015.pdf" target="_blank">Government’s Reply Opposing Vacatur</a>, August 31, 2015 <a href="Supplemental Brief from Hospital Plaintiffs Related to Remedies in FFY 2014 .2% Offset Case - Aug. 24, 2015" target="_blank">Supplemental Brief from Hospital Plaintiffs related to Remedies in FFY 2014 .2% offset case</a>, August 24, 2015 <a href="/system/files/media/file/2023/01/governments-supplemental-brief-related-to-remedies-in-ffy-2014-point-2-percent-offset-case-8-24-2015.pdf" target="_blank">Government’s Supplemental Brief related to Remedies in FFY 2014 .2% offset case</a>, August 24, 2015 FFY 2015 .2% offset challenge transfer to Judge Moss MINUTE ORDER granting [11] Unopposed Motion to Transfer the Case to Judge Moss. The Clerk is directed to transfer this case to Judge Randolph D. Moss. Signed by Judge Amit P. Mehta on 07/21/2015. (lcapm3) <a href="/system/files/media/file/2023/01/complaint-challenging-reduction-in-medicare-payment-rates-to-hospitals-for-inpatient-services-in-federal-fiscal-year-ffy-2015-5-19-2015.pdf" target="_blank">Complaint challenging reduction in Medicare payment rates to hospitals for inpatient services in federal fiscal year (FFY) 2015</a>, May 19, 2015 <a href="/system/files/media/file/2023/01/governments-reply-supporting-its-cross-motion-for-summary-judgment-motion-to-dismiss-re-.2-percent-offet-11-21-2014.pdf">Government’s Reply Supporting its Cross-motion for Summary Judgment/Motion to Dismiss</a>, November 21, 2014 <a href="/system/files/media/file/2023/01/aha-associations-hospitals-reply-brief-opposing-government-motion-to-dismiss-cross-motion-for-summary-judgment-re-.2-percent-offset-10-31-2014.pdf" target="_blank">AHA, Associations, Hospitals Reply Brief Opposing Government’s Motion to Dismiss/Cross-Motion for Summary Judgment</a>, October 31, 2014 <a href="/system/files/media/file/2023/01/government-response-to-motion-for-summary-judgment-re-0.2-percent-offset-complaint-10-15-2014.pdf" target="_blank">Government's response to&nbsp;our motion for summary judgment</a>, October 15, 2014 <a href="/system/files/media/file/2023/01/aha-association-hospitals-motion-for-summary-judgment-refiled-per-court-order-re-0.2-percent-offset-9-15-2014.pdf" target="_blank">AHA, Association, Hospitals Motion for Summary Judgment Refiled (per court order described below)</a>,&nbsp; September 15, 2014 <ul> <li><a href="http://Proposed Order Motion for briefing schedule in the AHA associations hospitals 2 midnight 2-percent offset case July 14 2014" target="_blank">Proposed Order</a></li> </ul> <a href="/content/14/140813offsetorder.txt">Court establishes briefing schedule in Consolidated 0.2 Percent Offset Cases</a>, August 13, 2014 <a href="/content/14/140723offsetminuteorder.pdf">Judge consolidates AHA, Associations, Hospitals .2% cut cases with other pending .2% offset cases</a>, July 23, 2014 <a href="/system/files/media/file/2023/02/motion-for-briefing-schedule-in-the-aha-associations-hospitals-2-midnight-2-percent-offset-case-7-14-2014.pdf" target="_blank">Motion for briefing schedule in the AHA, associations, hospitals' .2% offset case</a>, July 14, 2014 <ul> <li><a href="/system/files/media/file/2023/02/proposed-order-motion-for-briefing-schedule-in-aha-associations-hospitals-2-midnight-2-percent-offset-case-7-14-2014.pdf" target="_blank">Proposed Order</a></li> </ul> <a href="/system/files/media/file/2023/01/government-answers-aha-associations-hospitals-complaint-about-.2-percent-offset-6-17-2014.pdf" target="_blank">Government answers AHA, Associations, Hospitals complaint about .2% offset</a>, June 16, 2014 <a href="/system/files/media/file/2023/01/aha-associations-hospitals-motion-for-summary-judgment-re-0-2-percent-offset-5-23-2014.pdf" target="_blank">AHA, Associations, Hospitals Motion for Summary Judgment — 0.2 Percent Offset</a>, May 23, 2014&nbsp; <ul> <li><a href="/system/files/media/file/2023/01/aha-associations-hospitals-motion-for-summary-judgment-re-0-2-percent-offset-5-23-2014.pdf">[Proposed] Order</a></li> <li><a href="/system/files/media/file/2023/01/exhibit-a-aha-associations-hospitals-motion-for-summary-judgment-re-0-2-percent-offset-5-23-2014.pdf">Exhibit A</a></li> <li><a href="/system/files/media/file/2023/01/exhibit-b-aha-associations-hospitals-motion-for-summary-judgment-re-0-2-percent-offset-5-23-2014.pdf" target="_blank">Exhibit B</a></li> <li><a href="/system/files/media/file/2023/01/exhibit-c-aha-associations-hospitals-motion-for-summary-judgment-re-0-2-percent-offset-5-23-2014.pdf">Exhibit C</a></li> </ul> <a href="/system/files/media/file/2023/02/amicus-brief-aha-hospital-associations-hospitals-complaint-regarding-2-percent-payment-cut-4-14-14.zip" target="_blank">AHA, Hospital Associations, Hospitals Complaint Regarding .2% payment cut</a>, April 14, 2014 <a href="/news/news/2014-01-22-first-steps-taken-challenge-2-midnight-rule">First steps taken to challenge 2-midnight rule, AHA News Now</a>, January 22, 2014 <a href="/system/files/media/file/2023/02/prrb-appeal-hospital-.2-percent-payment-cut-1-21-2014.pdf" target="_blank">PRRB Appeal: .2 percent payment cut</a>&nbsp;&nbsp;&nbsp;&nbsp; <a href="/system/files/media/file/2023/02/Judge-dismisses-rebilling-complaint-9-17-2014.pdf" target="_blank">Judge dismisses rebilling complaint</a>, September 17, 2014 <a href="/system/files/media/file/2023/02/aha-supplemental-brief-changes-to-rebilling-policy-do-not-affect-aha-hospitals-current-legal-challenge-3-10-2014.pdf" target="_blank">Changes to rebilling policy do not affect AHA, Hospitals current legal challenge</a>, March 7, 2014 <a href="/system/files/media/file/2023/02/govt-response-to-aha-hospitals-march-7-2014-supplemental-brief-3-21-2014_0.pdf" target="_blank">Govt. Response to AHA, Hospitals’ March 7, 2014 Supplemental Brief</a> <a href="/system/files/media/file/2023/02/govt-supplemental-brief-on-the-effect-of-final-rule-on-defendants-motion-to-dismiss-oct-28-2013.pdf" target="_blank">Govt. Supplemental Brief on Impact of Final CMS Rule</a>, October 28, 2013 <a href="/system/files/media/file/2023/03/plaintiffs-supplemental-brief-on-impact-of-final-cms-rule-10-28-13.pdf" target="_blank">Plaintiffs’ Supplemental Brief on Impact of Final CMS Rule</a>, October 28, 2013 <a href="/system/files/media/file/2023/03/the-plaintiffs-opposition-to-defendants-motion-to-dismiss-6-27-2013.pdf" target="_blank">The Plaintiffs' Opposition to Defendant's Motion to Dismiss</a>, June 27, 2013 <a href="/system/files/media/file/2023/03/govt-motion-to-dismiss-complaint-06-06-2013.pdf" target="_blank">Govt. Motion to Dismiss Complaint</a>, June 6, 2013 <a href="/system/files/media/file/2023/03/govt-brief-in-support-of-its-motion-to-dismiss-complaint-07-23-2013.pdf" target="_blank">Govt. Brief in Support of Its Motion to Dismiss Complaint</a>, July 23, 2013&nbsp; <a href="/system/files/media/file/2023/03/second-amended-complaint-aha-hospitals-sue-hhs-on-part-b-rebilling-3-19-2023.pdf">Second Amended Complaint:&nbsp; AHA, Hospitals Sue HHS on Part B Rebilling</a> <a href="/system/files/media/file/2023/03/motion-for-expedited-status-conference-in-rac-rebilling-lawsuit.pdf" target="_blank">Motion for Expedited Status Conference&nbsp;in RAC Rebilling Lawsuit </a> <a href="/system/files/media/file/2023/03/motion-for-expedited-status-conference-in-rac-rebilling-lawsuit.pdf">Proposed Motion for Summary Judgment&nbsp;in RAC Rebilling Lawsuit</a> <a href="/system/files/media/file/2023/03/proposed-memorandum-of-points-and-authorities-in-support-of-motion-for-summary-judgment.pdf">Proposed Memorandum of Points and Authorities in Support of Motion for Summary Judgment</a> <a href="/system/files/media/file/2023/03/declaration-of-caroline-steinberg.pdf">Declaration of Caroline Steinberg</a> <a href="/system/files/media/file/2023/03/exhibit-a-to-proposed-motion-for-summary-judgment-missouri.pdf">Exhibit A to Proposed Motion for Summary Judgment</a> <a href="/system/files/media/file/2023/03/exhibit-b-to-proposed-motion-for-summary-judgment-dignity.pdf">Exhibit B to Proposed Motion for Summary Judgment</a> <a href="/system/files/media/file/2023/03/Proposed-order.pdf">Proposed Order </a> <a href="/system/files/media/file/2023/03/rebil-amended-complaint-aha-hospital-systems-sue-hhs.pdf">Amended Complaint: AHA, Hospital Systems Sue HHS </a> <a href="/system/files/media/file/2023/03/complaint-aha-hospital-systems-sue-hhs-for-unfair-medicare-practices-nov-1-2012.pdf">Complaint: AHA, Hospital Systems Sue HHS for Unfair Medicare Practices, Nov. 1, 2012</a> Tue, 20 Feb 2018 15:30:19 -0600 Legal Litigation: AHA, Hospitals Sue to Require HHS to Meet Deadlines for Deciding Appeals /legal/litigation-aha-hospitals-sue-require-hhs-meet-deadlines-deciding-appeals <hr /> <a href="/system/files/content/17/170811-cadc-opinion-alj-delay.pdf">Appeals court sends order to eliminate backlog of Medicare appeals back to trial court</a> (August 11, 2017) <a href="/system/files/2018-02/170406govtreply-aljdelay.pdf">Government's reply brief in the ALJ Delay Mandamus Appeal</a> (April 6, 2017) <a href="/system/files/2018-02/170323-appelleebrief-aljdelay.pdf">AHA, Hospitals Reply Brief</a> (and <a href="/system/files/2018-02/170323-stataddendum-aljdelay.pdf">Statutory Addendum</a>) in the Government’s appeal of the ALJ Delay mandamus order (March 23, 2017) <a href="/system/files/2018-02/170221govtopeningbrief.pdf">Government's brief</a> and <a href="/system/files/2018-02/170221jointappendix.pdf">Joint Appendix</a> in their appeal of the ALJ delay mandamus order (February 21, 2017) <a href="/system/files/content/17/170104aljdelayreconsdenied.pdf">Court rejects government's request to reconsider court order compelling HHS to reduce the appeals backlog</a> (January 4, 2017) <a href="/content/16/161221aljdelayoppreconsid.pdf">Opposition to government's motion for reconsideration</a>, Dec. 21, 2016 <a href="/system/files/2018-02/161115replybriefaljdelay.pdf">AHA, Hospital reply brief</a>, Nov. 15, 2016 <a href="/content/16/160919staydeniedappeals.pdf">Government's motion for stay DENIED,</a> Sept. 19, 2016 <a href="/content/16/160701timelyappealsgovreplybrief.pdf">Government’s reply brief</a>, July 1, 2016 <a href="/content/16/160613briefopposstay-alj.pdf">AHA, Hospitals Brief Opposing Stay</a> June 13, 2016 <ul> <li><a href="/content/16/160613proporder-alj.pdf">Proposed Order Denying Stay, Declaring ALJ Delays in Violation of Medicare Law,</a> June 13, 2016</li> </ul> <a href="/system/files/2018-02/160525-hhsmotionmemo.pdf">Govt. Motion to Stay Proceedings on Remand</a>, May 25, 2016 <ul> <li><a href="/system/files/2018-02/160525-hhsdeclaration.pdf">HHS Declaration in Support of Motion for Stay</a>, May 25, 2016</li> <li><a href="/system/files/2018-02/160525proposedorder.pdf">Proposed Order for Granting Stay</a>, May 25, 2016</li> </ul> <a href="/content/16/160209-aljdelayappealdecision.pdf">ALJ Delay Mandamus Appeal:&nbsp; D.C. Circuit Court Reverses Lower Court's Decision</a>, Feb. 9, 2016&nbsp; <a href="/system/files/2018-02/150715ahareplybriefaljdelay.pdf">AHA, Hospitals reply brief in ALJ delay appeal</a>, July 15, 2015 <a href="/system/files/2018-02/150701govtreplyaljdelay.pdf">Government's reply brief in ALJ delay appeal</a>, July 1, 2015 <a href="/system/files/2018-02/150508-aljdelayappgranted.pdf">Government's request for extra time to file responsive brief in appeal granted</a>, May 8, 2015 <a href="/system/files/2018-02/150507aljdelay-oppexten.pdf">AHA, hospitals oppose request to extend time for government’s response</a>, May 7, 2015 <a href="/system/files/2018-02/150504briefaljdelay.pdf">Opening appeal brief from AHA, hospitals</a>, May 4, 2015 <a href="/content/14/141218-aljdelay-opinion.pdf">Court dismisses ALJ delay case</a>, Dec. 18, 2014 <a href="/content/14/141017hhsbriefappeals.pdf">Government's brief in support of its motion to dismiss</a>, Oct 17, 2014 <ul> <li><a href="/content/14/141017griswolddeclaration.pdf">Declaration of Nancy J. Griswold Chief Administrative Law Judge of Office of Medicare Hearings and Appeals</a></li> <li><a href="/content/14/141017cashdeclaration.pdf">Declaration of Lester D. Cash</a></li> </ul> <a href="/content/14/141002-alj-opposition-reply.pdf">AHA, Hospitals brief opposing govt. motion to dismiss, further supporting our motion for summary judgment</a>, Oct. 2, 2014 <a href="/content/14/140911govtoppostomsj.pdf">Government responds to AHA, Hospitals complaint and motion for summary judgment</a>, Sept. 11, 2014 <ul> <li><a href="/content/14/140911govtmotiontodismiss.pdf">Government's motion to dismiss</a></li> <li><a href="/content/14/140911tobiasdecl.pdf">Declaration of Constance B. Tobias</a> <ul> <li><a href="/content/14/140911ex1totobias.pdf">Exhibit 1&nbsp;</a>&nbsp;</li> </ul> </li> <li><a href="/content/14/140911griswolddecl.pdf">Declaration of Nancy J. Griswold</a> <ul> <li><a href="/content/14/140911ex1togriswold.pdf">Exhibit 1 </a></li> <li><a href="/content/14/140911ex2togriswolddecl.pdf">Exhibit 2 </a></li> </ul> </li> </ul> <a href="/content/14/140829minordbriefschedaljdelay.txt">Briefing Schedule Set in ALJ Delay Litigation</a>, Aug. 29, 2014&nbsp; MINUTE ORDER granting the parties' Joint [11] Motion for Briefing Schedule. The Court ORDERS that the Plaintiffs shall file a consolidated brief in opposition to Defendant's forthcoming Motion to Dismiss and reply in support of Plaintiffs' Motion for Summary Judgment, not to exceed forty-five pages, on or before October 2, 2014; and Defendant shall file a reply brief in support of her forthcoming Motion to Dismiss on or before October 17, 2014. Signed by Judge James E. Boasberg on 08/29/14. (lcjeb1) <a href="/content/14/140829motionsetbriefsched.pdf">Parties Jointly Request Briefing Schedule</a>, Aug. 29, 2014 <ul> <li><a href="/content/14/140829proporder.pdf">Proposed Order</a></li> </ul> <a href="/content/14/140722aljdelayextensiongranted.txt">Government's motion for extension of time to respond granted</a>, July 22, 2014 MINUTE ORDER GRANTING Defendant's 9 Motion for Extension of Time to Respond to Complaint and Plaintiff's Motion for Summary Judgment. The Court ORDERS that Defendant shall respond to the Complaint and to Plaintiffs' Motion for Summary Judgment on or before September 11, 2014. Signed by Judge James E. Boasberg on 7/22/2014. (lcjeb3) <a href="/content/14/140722-motion-denyhhsexten.pdf">AHA, Hospitals Oppose Government’s Request for Delay</a>, July 22, 2014 <ul> <li><a href="/content/14/140722-proporder-denyextension.pdf">Proposed Order</a></li> </ul> <a href="/content/14/140721-dojmotionextension.pdf">DOJ Requests 45-Day Extension to Respond to ALJ Delay Lawsuit</a>, July 21, 2014 <a href="/content/14/140711-judgesum-alj-delay-lawsuit.pdf">AHA, Hospitals’ Motion for Summary Judgment ALJ Delay Lawsuit</a>, July 11, 2014&nbsp;&nbsp; <ul> <li><a href="/content/14/140711-proporder-alj-delay-suit.pdf">[Proposed Order]</a></li> <li><a href="/content/14/140711-ex1-medadmin-appeals.pdf">Exhibit 1:&nbsp; Medicare Administrative Appeals Process</a></li> <li><a href="/content/14/140711-ex2-omha-2-12-slides.pdf">Exhibit 2: &nbsp;OMHA Feb 12 Forum Presentation Slides</a></li> <li><a href="/content/14/140711-ex3-omha-12-24-mem-mora.pdf">Exhibit 3:&nbsp; OMHA Dec 24 Memo re Moratorium</a></li> <li><a href="/content/14/140711-ex4.pdf">Exhibit 4:&nbsp; OMHA Adjudication Timeframes and Statistics</a></li> <li><a href="/content/14/140711-ex5.pdf">Exhibit 5:&nbsp; Results from AHA RACTRAC Survey, 1st Quarter &nbsp;2014</a></li> <li><a href="/content/14/140711-ex6.pdf">Exhibit 6:&nbsp; Article from Inside Health Policy - ALJs Lay Path Forward For Stakeholders As Appeals Backlog Continues</a></li> <li><a href="/content/14/140711-ex7.pdf">Exhibit 7:&nbsp; July 10, 2014 Statement of Chief ALJ Griswold before Subcommittee of the House Committee on Oversight and Government Reform</a></li> <li><a href="/content/14/140711-ex8.pdf">Exhibit 8:&nbsp; Feb. 12, 2014 AMA Letter to Chief ALJ Griswold re appeals backlog</a></li> <li><a href="/content/14/140711-ex9.pdf">Exhibit 9:&nbsp; March 27, 2014 AdvaMed letter to Sec. Sebelius re OHMA moratorium</a></li> </ul> <a href="/ahanews/jsp/display.jsp?dcrpath=AHANEWS/AHANewsNowArticle/data/ann_071114_motion&amp;domain=AHANEWS" target="_blank">AHA, hospitals ask court to compel HHS to meet hearing deadlines</a>,&nbsp;July 11, 2014 <a href="/system/files/media/file/2023/04/aha-hospitals-mandamus-complaint-to-compel-timely-administrative-review-of-Medicare-claims-denials-5-22-2014.pdf" target="_blank">AHA, hospitals mandamus complaint to compel timely administrative review of Medicare claims denials</a>, May 22, 2014&nbsp; <ul> <li><a href="/content/14/140522complaint-exhibit1.pdf">Exhibit 1</a></li> <li><a href="http://www.ahanews.com/ahanews/jsp/display.jsp?dcrpath=AHANEWS/AHANewsNowArticle/data/ann_052214_ALJ&amp;domain=AHANEWS">AHA News Now article</a></li> </ul> Tue, 20 Feb 2018 15:01:16 -0600 Legal