/ en Fri, 25 Apr 2025 16:17:10 -0500 Wed, 06 Nov 24 16:00:00 -0600 <div class="container"><div class="row"><div class="col-md-8"><h3><strong>The Centers for Medicare & Medicaid Services’ Hospital Price Transparency final rule goes into effect on Jan. 1, 2021.</strong></h3><h2>Issue</h2><p>The Centers for Medicare & Medicaid Services’ (CMS) hospital price transparency final rule, issued Nov. 14, 2019, will require hospitals to provide an out-of-pocket price estimator tool or information on 300 “shoppable” services for patients as well as disclose their privately negotiated rates with health insurers, discounted cash prices and gross charges beginning Jan. 1, 2021. The agency will monitor and enforce compliance, including civil monetary penalties of up to $300 a day</p><h2>AHA Take</h2><p>Hospitals and health systems are committed to providing patients with meaningful information that patients can use to make the best decisions for themselves and their families, such as an out-of-pocket cost-estimator tool for shoppable services. However, the AHA continues to oppose the requirement to publicly list privately negotiated prices. That part of the rule will do nothing to help patients become more knowledgeable consumers of health care and instead will confuse and frustrate them. And, according to one large national health insurer, it will accelerate anticompetitive behavior by insurers with market power including stymieing badly needed innovations in care delivery.</p><p>The U.S. Court of Appeals for the District of Columbia Circuit Oct.15 heard oral arguments in an appeal from the AHA and hospital groups challenging CMS’ final rule. We urged the court to overturn the rule and do so quickly due to the looming Jan.1 compliance deadline and the unreasonable burden it places on hospitals. Concurrent with our legal strategy, we have been working to prepare the field for the rule’s implementation, should it take effect on Jan. 1.</p><h2>AHA Resources</h2><p>AHA offers resources to help you meet patient demand for easier access to out-of-pocket cost estimates. These resources also can help you implement the hospital price transparency rule shoppable service requirement. We also partnered with AVIA, a digital health consultant firm, and Deloitte to create educational opportunities related to implementation.</p><p>See below for a collection of all AHA and CMS resources related to this final rule. This webpage will be updated regularly as new resources are available.</p><hr><p><a class="ck-anchor" id="ptvideo"></a></p><p>AHA members, <a href="/system/files/media/video/2020/12/AHA-Price-Transparency-Version-A.mp4">download an unbranded version of this video</a> to share with your communities on your website. Use the "Download" or "Save video as" link within the video player option menu to download the .mp4 video file. You may need to right click on the video for this menu to appear.</p><hr><div class="col-md-12 cc_tabs">/* reset */ .cc_tabs ul.a-container { margin: 0; padding: 0; list-style: none; } .cc_tabs input[type=checkbox] { display: none; } /* style */ .cc_tabs .a-container { width: 100%; margin: 20px auto; } .cc_tabs .a-container label { display: block; position: relative; cursor: pointer; font-size: 18px; font-weight: bold; padding: 10px 20px; color: #63666a; background-color: #eee; border-bottom: 1px solid #ddd; -webkit-transition: all .2s ease; -moz-transition: all .2s ease; -ms-transition: all .2s ease; -o-transition: all .2s ease; transition: all .2s ease; margin-bottom:15px } .cc_tabs .a-container label:after { content: ""; width: 0; height: 0; border-top: 8px solid #aaa; border-right: 6px solid transparent; border-bottom: 8px solid transparent; border-left: 6px solid transparent; position: absolute; right: 10px; top: 16px; } .cc_tabs .a-container input:checked + label, .cc_tabs .a-container label:hover { background-color: #003087; 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display: none; height:auto; max-height: 40vh; overflow: auto } .cc_tabs .a-container input:checked ~ .a-content { display: block; } /* Style the tab */ .cc_tabs .tab { background-color: #fff; width: auto; height: auto; overflow: auto; } /* Style the buttons inside the tab */ .cc_tabs .tab button { display: block; background-color: lightgry; color: #003087; padding: 10px 16px 10px 20px; width: calc(50% - 30px); border: solid 1px lightgray; outline: none; text-align: center; cursor: pointer; transition: 0.3s; font-size: 20px; float: left; overflow: auto; margin: 0px 15px; -webkit-border-top-left-radius: 15px; -webkit-border-top-right-radius: 15px; -moz-border-radius-topleft: 15px; -moz-border-radius-topright: 15px; border-top-left-radius: 15px; border-top-right-radius: 15px; font-weight: 700; } @media (max-width:452px){ .cc_tabs .tab button{ padding: 10px 5px 10px 5px; width: calc(50% - 4px); font-size: 17px; margin: 0px 2px; } } /* Change background color of buttons on hover */ .cc_tabs .tab button:hover { background-color: #003087; color:#fff } /* Create an active/current "tab button" class */ .cc_tabs .tab button.active { background-color: #003087; color: #ffffff } /* Style the tab content */ .cc_tabs .tab .tabcontent { float: left; padding: 15px 12px; border: 1px solid #ccc; width: 100%; height: auto; } .cc_tabs .tablinks:after { content: '\2610'; color: #777; font-weight: bold; float: right; margin-left: 5px; } .cc_tabs .tablinks.active:after { content: "\2611"; } Get CertifiedRecertify </div> --> <div class="tabcontent" id="General"> <a id="patienttools"> </a> <a id="patienttools"></a> <ul class="a-container"> <li class="a-items"> Rule Summary <div class="a-content"> <ul> <li> <a href="/special-bulletin/2021-11-03-cms-issues-hospital-outpatientasc-final-rule-including-modifications">Special Bulletin: CY 2022 Hospital OPPS/ASC Final Rule, Including Modifications to Price Transparency </a> </li> <li> <a href="/advisory/2021-07-30-cy-2022-hospital-oppsasc-proposed-rule-including-modifications-price">CY 2022 Hospital OPPS/ASC Proposed Rule, Including Modifications to Price Transparency</a> </li> <li> <a href="/2021-07-20-cms-issues-hospital-outpatientasc-proposed-rule-including-modifications-price">AHA Special Bulletin on Proposed Updates to Rule</a> </li> <li> <a href="/advisory/2019-12-04-regulatory-advisory-administration-finalizes-rule-requiring-disclosure-hospital">AHA Regulatory Advisory</a> </li> <li> <a href="/special-bulletin/2019-11-15-special-bulletin-administration-issues-two-rules-disclosure-hospital">AHA Special Bulletin</a> </li> </ul> </div> </li> <li class="a-items"> AHA Advocacy <div class="a-content"> <ul> <li> <a href="/lettercomment/2021-03-16-aha-comments-no-surprises-acts-price-transparency-provisions">AHA letter to CMS on Implementing the No Surprises Act’s Price Transparency Provisions </a> </li> <li> <a href="/lettercomment/2021-01-07-aha-urges-hhs-exercise-enforcement-discretion-respect-hospital-price">AHA Letter Urging Sec. Azar to Exercise Enforcement Discretion with Respect to the Hospital Price Transparency Rule</a> </li> <li> <a href="/special-bulletin/2020-12-21-aha-urges-court-delay-implementation-price-transparency-rule">AHA Special Bulletin: AHA Urges Court to Delay Implementation of Price Transparency Rule; Asks Biden Transition Team for Enforcement Discretion</a> </li> <li> <a href="/lettercomment/2020-12-21-aha-letter-biden-harris-transition-team-price-transparency-rule">AHA Letter to Biden-Harris Transition Team on Price Transparency Rule</a> </li> <li> <a href="/lettercomment/2020-12-11-aha-outlines-initial-policy-priorities-biden-administration">AHA Letter to President-elect Biden (includes request for delay in enforcement)</a> </li> <li> <a href="/lettercomment/2020-12-02-aha-hhs-re-additional-covid-19-flexibilities-providers">Letter to Sec. Azar re: Additional COVID-19 Flexibilities (includes request for delay in enforcement)</a> </li> <li> <a href="/system/files/media/file/2019/09/aha-comments-cms-outpatient-pps-asc-proposed-rule-cy-2020-9-27-19.pdf">AHA Comments on the Proposed Policy</a> </li> <li> <a href="/lettercomment/2020-07-06-aha-urges-hhs-delay-effective-date-hospital-price-transparency-rule">AHA Letter requesting a delay</a> </li> </ul> </div> </li> <li class="a-items"> AHA Lawsuit <div class="a-content"> <a> </a> <p class="MsoNormal"> <span></span> </p> <ul> <li> <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) </li> <li> <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> </li> </ul> <ul> <li> <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) </li> <li> <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) </li> <li> <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) </li> <li> <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) </li> <li> <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) </li> <li> <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) </li> <li> <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) </li> <li> <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) </li> <li> <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) </li> <li> <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) </li> <li> <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) </li> <li> <a href="/legal-documents/2020-07-17-opening-appeals-brief-re-disclosure-negotiated-charges-july-17-2020">Opening Appeals Brief</a> (July 17, 2020) </li> <li> <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) </li> <li> <a href="/legal-documents/2020-07-06-motion-expedite-appeal-july-3-2020">Motion to Expedite Appeal</a> (July 3, 2020) </li> <li> <a href="/legal-documents/2020-06-24-notice-appeal-court-decision-public-disclosure-negotiated-rates-june-23">Notice of Appeal</a> (June 23, 2020) </li> <li> <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) </li> <li> <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) </li> <li> <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) </li> <li> <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) </li> <li> <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) </li> <li> <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) </li> <li> <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) </li> <li> <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) </li> <li> <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) </li> <li> <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) </li> <li> <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) </li> </ul> </div> </li> <li class="a-items"> AHA Member Resources for Implementation <div class="a-content"> <h4> Internal Communications Tools for Hospitals </h4> <ul> <li> <a href="/2024-04-18-webinar-recording-navigating-implementation-hospital-price-transparency-machine-readable-file-changes-cms">Webinar Recording: Navigating Implementation of the Hospital Price Transparency Machine-readable File Changes with CMS</a> </li> <li> <a href="/other-resources/2020-12-17-price-transparency-action-items">Price Transparency Action Items</a> </li> <li> <a href="/infographics/2020-12-17-communicating-about-price-transparency">Communicating About Price Transparency</a> </li> <li> <a href="/infographics/2020-12-22-hospital-price-transparency-infographic">Price Transparency Infographic</a> </li> <li> <a href="/2020-12-18-price-transparency-sample-patient-and-media-messages">Price Transparency Sample Patient and Media Messages</a> </li> <li> <a href="/other-resources/2020-12-17-price-transparency-secret-shopper-exercise">Price Transparency Secret Shopper Exercise</a> </li> <li> <a href="/assessment/2020-12-17-price-transparency-self-assessment">Price Transparency Self-assessment</a> </li> <li> <a href="/2020-12-18-price-transparency-tough-questions-answers">Price Transparency Tough Questions and Answers</a> </li> </ul> <h4> Other Resources </h4> <ul> <li> <a href="/special-bulletin/2021-08-23-departments-hhs-labor-and-treasury-release-faqs-transparency-no">AHA Special Bulletin: Departments of HHS, Labor, and Treasury Release FAQs on Transparency, No Surprises Act Regulations</a> </li> <li> <a href="/special-bulletin/2021-08-11-updated-aha-guidance-hospital-price-transparency-rule-took-effect-jan-1">AHA Special Bulletin: Updated AHA Guidance on Hospital Price Transparency Rule That Took Effect Jan. 1 </a> </li> <li> <a href="/advisory/2021-05-03-cms-begins-issuing-warning-notices-hospitals-noncompliance-hospital-price">AHA Member Advisory: CMS Begins Issuing Warning Notices to Hospitals for Noncompliance with Hospital Price Transparency Rule</a> </li> <li> <a href="/advisory/2020-12-22-media-guidance-and-other-new-resources-available-prepare-hospital-price">AHA Member Advisory: Media Guidance and Other New Resources Available to Prepare for Hospital Price Transparency Rule That Takes Effect Jan. 1, Dec. 22, 2020 </a> </li> <li> <a href="/podcasts/2020-12-03-podcast-price-transparency-and-out-pocket-calculators">Podcast: Price Transparency and Out-of-pocket Calculators</a> </li> <li> <a href="/webinars/2020-11-05-webinar-strategies-and-solutions-cleverley-associates-prepare-cmss-hospital">Cleverley + Associates Webinar on Strategies and Solutions</a> </li> <li> <a href="/webinars/2020-11-05-webinar-strategies-and-solutions-para-healthcare-analytics-prepare-cmss">PARA Healthcare Analytics Webinar on Strategies and Solutions</a> </li> <li> <a href="/2020-10-30-hospital-price-transparency-rule-goes-effect-jan-1-aha-resources-help-members-prepare">AHA Member Advisory</a> </li> <li> <a href="/2020-10-27-patient-cost-estimator-toolkit">Patient Out-of-pocket Cost Estimator Toolkit </a>(includes Members in Action case studies) </li> <li> <a href="https://connect.aviahealthinnovation.com/intelligence/km/graph?id=2226&activeTab=Feed">AVIA Connect Virtual Panel on Implementation</a> (access granted with AHA.org log-in information) </li> <li> <a href="https://aviahealthinnovation.zoom.us/rec/play/X1jytuRlrriT9np6MLgNeyKsOT7PuPsHZN6N0vqZ6qVielWRFjTsTRfTqh8WUSzb3NCuD_zWdkpRPnGH.pluDldINDeHoG2o3?startTime=1600887611000">AVIA-Deloitte Webinar on Strategic Considerations for Implementation</a> (access granted with AHA.org log-in information) </li> <li> <a href="/advocacy-webinar-recording/2021-08-30-webinar-price-transparency-policy-updates">Webinar: Price Transparency Updates on August 25, 2021</a> </li> </ul> </div> </li> <li class="a-items"> CMS Resources <div class="a-content"> <ul> <li> <a href="https://www.cms.gov/hospital-price-transparency/hospitals">CMS Hospital Transparency Website</a> </li> <li> <a href="https://www.govinfo.gov/content/pkg/FR-2019-11-27/pdf/2019-24931.pdf">FY 2020 Price Transparency Requirements for Hospitals To Make Standard Charges Public</a> </li> <li> <a href="https://www.cms.gov/files/document/hospital-price-transparency-frequently-asked-questions.pdf">Frequently Asked Questions</a> </li> <li> <a href="https://www.cms.gov/files/document/steps-machine-readable-file.pdf">8 Steps to a Machine-readable File</a> </li> <li> <a href="https://www.cms.gov/files/document/steps-making-public-standard-charges-shoppable-services.pdf">10 Steps to a Consumer-Friendly Display</a> </li> <li> <a href="https://www.cms.gov/files/document/hospital-price-transparency-final-rule-quick-reference-checklists.pdf">Quick Reference Checklist</a> </li> </ul> </div> </li> <li class="a-items"> AHA Resources on Related Policies <div class="a-content"> <ul> <li> <a href="/advisory/2021-10-26-member-advisory-update-federal-price-transparency-policies">Member Advisory: Update on Federal Price Transparency Policies </a> </li> <li> <a href="/surprise-billing">AHA’s Surprise Billing Webpage </a> </li> <li> <a href="/special-bulletin/2020-10-29-administration-finalizes-rule-requiring-health-plans-disclose">Special Bulletin: Administration Finalizes Rule Requiring Health Plans to Disclose Negotiated Rates</a> </li> <li> <a href="/special-bulletin/2019-11-15-special-bulletin-administration-issues-two-rules-disclosure-hospital">Special Bulletin: Proposed Insurer Price Transparency Policy</a> </li> <li> <a href="/lettercomment/2020-01-29-aha-comments-cms-transparency-coverage-proposed-rule">AHA comments on Proposed Insurer Price Transparency Policy</a> </li> <li> <a href="/system/files/2018-12/181211-advisory-transparency.pdf">AHA Advisory – 2019 Update to Disclosure of Standard Charge Policy</a> </li> </ul> </div> </li> </ul> </div> <ul class="a-container"> item 1 <div class="a-content"> <p> ==== </p> </div> </li> </ul> <div> --> function openCity(evt, cityName) { var i, tabcontent, tablinks; tabcontent = document.getElementsByClassName("tabcontent"); for (i = 0; i < tabcontent.length; i++) { tabcontent[i].style.display = "none"; } tablinks = document.getElementsByClassName("tablinks"); for (i = 0; i < 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(); </div> </div><p> </p></div> <ul class="a-container"> item 1 <div class="a-content"> <p> ==== </p> </div> </li> </ul> <div> --> function openCity(evt, cityName) { var i, tabcontent, tablinks; tabcontent = document.getElementsByClassName("tabcontent"); for (i = 0; i < tabcontent.length; i++) { tabcontent[i].style.display = "none"; } tablinks = document.getElementsByClassName("tablinks"); for (i = 0; i < 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(); </div></div><div class="col-md-4"><p class="text-align-center"> </p><p class="text-align-center"> </p><p class="text-align-center"><a class="btn btn-primary btn-wide" href="/advisory/2020-12-22-media-guidance-and-other-new-resources-available-prepare-hospital-price"><strong>December 22 AHA Advisory with New Resources to Prepare for Hospital Price Transparency Rule That Takes Effect Jan. 1</strong></a></p><p> </p><div class="panel module-typeC"><div class="panel-heading"><h3 class="panel-title">Key Takeaways</h3></div><div class="panel-body"><p>As of Jan. 1, 2021, hospitals are required to:</p><ul><li>Post a list of five types of standard charges – now defined as gross charges, payer-specific negotiated rates, de-identified minimum and maximum negotiated rates, and discounted cash price – for all items and services in a machine-readable format on their websites.</li><li>Provide payer-specific rates for at least 300 “shoppable” bundles of services in a consumer-friendly format. Hospitals with a qualified price estimator tool meet this requirement.</li></ul><p>Noncompliance is subject to civil monetary penalties.</p><p>The AHA and three other national organizations sued the federal government challenging the final rule; the case is pending an appeal.</p></div></div></div></div></div> Mon, 12 Apr 2021 16:34:23 -0500 Legal Documents /legal-documents/2024-11-06-american-hospital-association-2023-irs-form-990 <div class="container"><div class="row"><div class="col-md-8"><h2 class="text-align-left">Public Disclosure Copy</h2><h3 class="text-align-left">���������� Association IRS Form 990</h3><div class="external-link spacer"><a class="btn btn-wide btn-primary" href="/system/files/media/file/2024/11/2023-AHA-Form-990-Public-Disclosure-Copy.pdf" target="_blank" title="���������� Association 2023 IRS Form 990 Public Disclosure Copy PDF">Download the Complete AHA 2023 IRS Form 990</a></div></div><div class="col-md-4"><div class="panel module-typeC"><div class="panel-heading"><h3 class="panel-title">AHA IRS Form 990 from Previous Year</h3></div><div class="panel-body"><ul><li><a href="/system/files/media/file/2023/11/American-Hospital-Association-2022-IRS-Form-990.pdf">2022</a></li></ul></div></div></div></div><div class="row"><div class="col-md-8"><p> </p></div></div></div> Wed, 06 Nov 2024 16:00:00 -0600 Legal Documents /legal-documents/2024-09-30-abbvie-inc-et-al-astrazeneca-pharmaceuticals-lp-pharmaceutical-research-and-manufacturers-america-vs <p class="text-align-center"><strong>UNITED STATES DISTRICT COURT</strong><br><strong>WESTERN DISTRICT OF LOUISIANA</strong><br><strong>LAFAYETTE DIVISION</strong><br> </p><p>PHARMACEUTICAL RESEARCH AND         CASE NO. 6:23-CV-00997<br>MANUFACTURERS OF AMERICA  <br>VERSUS                                                      JUDGE ROBERT R. SUMMERHAYS<br>LIZ MURRILL                                              MAGISTRATE JUDGE<br>                                                                  CAROL B. WHITEHURST<br>*<br>ASTRAZENECA PHARMACEUTICALS LP   CASE NO. 6:23-CV-01042<br>VERSUS<br>LIZ MURRILL                                                                                       <br>*<br>ABBVIE, INC., ET AL                                   CASE NO. 6:23-CV-01307<br>VERSUS<br>LIZ MURRILL                            <br>*</p><p class="text-align-center"><br><strong>MEMORANDUM RULING</strong><br> </p><p>          Presently before the Court in three related matters are: (1) Motions for Summary Judgment filed by Plaintiffs AstraZeneca Pharmaceuticals LP (“AstraZeneca”), AbbVie, Inc. (“AbbVie”), and Pharmaceutical Research and Manufacturers of America (“PRMA”) (collectively, “Plaintiffs”);1 (2) Cross Motions for Summary Judgment2 by defendant, Liz Murrill; and (3) Cross Motions for Summary Judgment3 by the intervenor, Louisiana Primary Care Association (“LPCA”). The Court held a consolidated hearing on the various motions on June 6, 2024. After oral arguments, the Court took all the motions under advisement.</p> Mon, 30 Sep 2024 15:23:40 -0500 Legal Documents /legal-documents/2024-06-29-opinion-order-american-hospital-association-et-al-v-xavier-becerra-et-al <p class="text-align-center"><strong>UNITED STATES DISTRICT COURT</strong><br><strong>FOR THE NORTHERN DISTRICT OF TEXAS</strong><br><strong>FORT WORTH DIVISION</strong><br> </p><p>AMERICAN HOSPITAL ASSOCIATION,<br>ET AL.,<br>Plaintiffs,<br><br>v.                                                        No. 4:23-cv-01110-P<br><br>XAVIER BECERRA, ET AL.,<br>Defendants.<br> </p><p class="text-align-center"><strong>OPINION & ORDER</strong></p><p>Before the Court are cross-motions for summary judgment. ECF Nos. 24, 50. Having considered the motions, briefs, and applicable law, the Court GRANTS in part and DENIES in part Plaintiffs’ motion (ECF No. 24) and DENIES Defendants’ motion (ECF No. 50).</p><p class="text-align-center"><strong>BACKGROUND</strong></p><p>Congress passed the Health Insurance Portability and Accountability Act (“HIPAA”) in 1996 because health information needed more protections and the world needed more acronyms. HIPAA seeks to “assure that individuals’ health information is properly protected” while “allowing the flow of health information needed to provide and promote high quality healthcare.” The Department of Health and Human Services (“HHS”) enforces this mandate. Violations are reported to HHS’s Office for Civil Rights (“OCR”), who investigates reports and recommends corrective action. This case involves HIPAA’s confidentiality protections (the “Privacy Rule”) for “protected health information” (“PHI”). More specifically, the case concerns the Rule’s applicability to one subset of PHI: “individually identifiable health information” (“IIHI”). HIPAA defines IIHI as information that (1) “relates to” an individual’s healthcare and (2) “identifies the individual” or provides “a reasonable basis to believe that the information can be used to identify the individual.” </p><p>View the detailed order below.</p> Sat, 29 Jun 2024 17:20:00 -0500 Legal Documents /legal-documents/2024-04-12-plaintiffs-reply-aha-v-rainer-case-april-11-2024 <p class="text-align-center"><strong>IN THE UNITED STATES DISTRICT COURT </strong><br><strong>FOR THE NORTHERN DISTRICT OF TEXAS</strong><br><strong>FORT WORTH DIVISION</strong></p><p>AMERICAN HOSPITAL ASSOCIATION, et al.,</p><p>                                     Plaintiffs,</p><p>v.                                                                              No. 4:23-cv-1110-P</p><p>BECERRA, et al., <br>                                    Defendants.<br><br> </p><p class="text-align-center"><strong>PLAINTIFFS’ COMBINED BRIEF IN OPPOSITION TO DEFENDANTS’ CROSS-MOTION FOR SUMMARY JUDGMENT AND REPLY BRIEF IN SUPPORT OF PLAINTIFFS’ MOTION FOR SUMMARY JUDGMENT</strong><br> </p><table><tbody><tr><td>Jonathan D. Guynn (TX 24120232)<br>JONES DAY<br>2727 N. Harwood St., Ste. 500<br>Dallas, Texas 75201<br>(214) 220-3939<br>(214) 969-5100 (fax)<br><a class="ck-anchor" href="mailto:jguynn@jonesday.com" id="mailto:jguynn@jonesday.com">jguynn@jonesday.com</a><br><br><br><br><br> </td><td>Hashim M. Mooppan* (DC 981758)<br>Rebekah B. Kcehowski* (PA 90219)<br>Audrey Beck* (DC 1739917)<br>JONES DAY<br>51 Louisiana Ave., N.W.<br>Washington, D.C. 20001<br>(202) 879-3939<br>(202) 626-1700 (fax)<br>hmmooppan@jonesday.com<br>rbkcehowski@jonesday.com<br>abeck@jonesday.com<br><em>* Pro hac vice</em></td></tr></tbody></table><p>                                  <em>    Counsel for Plaintiffs</em><br> </p> Fri, 12 Apr 2024 15:00:47 -0500 Legal Documents /legal-documents/2024-01-10-aha-amicus-brief-adventist-health-system-sunbelt-healthcare-corporation-vs-multiplan-inc-litigation <p class="text-align-center">Case 1:23-cv-07031-ER Document 69-1 Filed 01/09/24 </p><p class="text-align-center"><strong>UNITED STATES DISTRICT COURT</strong><br><strong>FOR THE SOUTHERN DISTRICT OF NEW YORK</strong><br> </p><p> </p><p>ADVENTIST HEALTH SYSTEM SUNBELT<br>HEALTHCARE CORP.,</p><p>                                                                                      Plaintiff,                <br>v.                                                                                                       Civil Action No. 1:23-CV-07031-ER-KP   </p><p>MULTIPLAN, INC.,                                                       Defendant.<br><br><strong>BRIEF OF THE AMERICAN HOSPITAL ASSOCIATION AS AMICUS CURIAE IN RESPONSE TO DEFENDANT MULTIPLAN, INC.’S MOTION TO DISMISS</strong></p> Tue, 09 Jan 2024 23:34:57 -0600 Legal Documents /legal-documents/2024-01-05-aha-files-brief-lawsuit-challenging-hhs-rule-information-sharing <p class="text-align-center">Case 4:23-cv-01110-P Document 25 Filed 01/05/24 Page 1 of 44 PageID 112</p><p class="text-align-center"><strong>IN THE UNITED STATES DISTRICT COURT</strong><br><strong>FOR THE NORTHERN DISTRICT OF TEXAS</strong><br><strong>FORT WORTH DIVISION</strong><br> </p><p>AMERICAN HOSPITAL ASSOCIATION,<br>et al.,<br>                                             Plaintiffs,<br>v.<br>BECERRA, et al.,<br>                                             Defendants.<br>                                                                                         No. 4:23-cv-1110-P<br> </p><p class="text-align-center"><strong>PLAINTIFFS’ BRIEF IN SUPPORT OF MOTION FOR SUMMARY JUDGMENT</strong></p><table><tbody><tr><td>Jonathan D. Guynn (TX 24120232)<br>JONES DAY<br>2727 N. Harwood St., Ste. 500<br>Dallas, Texas 75201<br>(214) 220-3939<br>(214) 969-5100 (fax)<br>jguynn@jonesday.com  <br><br><br><br><br><br><br>   </td><td>Hashim M. Mooppan* (DC 981758)<br>Rebekah B. Kcehowski* (PA 90219)<br>Jack L. Millman* (NY 5517180)<br>Audrey Beck* (DC 1739917)<br>JONES DAY<br>51 Louisiana Ave., N.W.<br>Washington, D.C. 20001<br>(202) 879-3939<br>(202) 626-1700 (fax)<br>hmmooppan@jonesday.com<br>rbkcehowski@jonesday.com<br>jmillman@jonesday.com<br>abeck@jonesday.com<br>* Pro hac vice</td></tr></tbody></table><p>Counsel for Plaintiffs</p><p>View the entire brief below.</p> Fri, 05 Jan 2024 13:08:38 -0600 Legal Documents /legal-documents/2023-11-02-case-complaint-aha-tha-thr-united-health-care-system-v-rainer <div class="container"> <div class="row"> <div class="col-md-8"> <p><strong>IN THE UNITED STATES DISTRICT COURT FOR THE NORTHERN DISTRICT OF TEXAS FORT WORTH DIVISION</strong></p> <div class="row"> <div class="col-md-6"> <p>AMERICAN HOSPITAL ASSOCIATION; TEXAS HOSPITAL ASSOCIATION; TEXAS HEALTH RESOURCES; UNITED REGIONAL HEALTH CARE SYSTEM,</p> <p>Plaintiffs,</p> <p>v.</p> <p>MELANIE FONTES RAINER, IN HER OFFICIAL CAPACITY AS DIRECTOR OF OFFICE FOR CIVIL RIGHTS, U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES; XAVIER BECERRA, IN HIS OFFICIAL CAPACITY AS SECRETARY OF U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES; UNITED STATES OF AMERICA,</p> <p>Defendants.</p> </div> <div class="col-md-1"> <p>|<br> |<br> |<br> |<br> |<br> |<br> |<br> |<br> |<br> |<br> |<br> |<br> |<br> |<br> |<br> |<br> |</p> </div> <div class="col-md-5"> <p>NO.</p> </div> </div> <p><strong>COMPLAINT</strong></p> <div class="row"> <div class="col-md-6"> <p>Jonathan D. Guynn (TX 24120232)<br> JONES DAY<br> 2727 N. Harwood St., Ste. 500<br> Dallas, Texas 75201<br> (214) 220-3939<br> (214) 969-5100 (fax)<br> jguynn@jonesday.com</p> </div> <div class="col-md-6"> <p>Hashim M. Mooppan* (DC 981758)<br> Rebekah B. Kcehowski* (PA 90219)<br> Jack L. Millman* (NY 5517180)<br> Audrey Beck* (DC 1739917)<br> JONES DAY<br> 51 Louisiana Ave., N.W.<br> Washington, D.C. 20001<br> (202) 879-3939<br> (202) 626-1700 (fax)<br> hmmooppan@jonesday.com<br> rbkcehowski@jonesday.com<br> jmillman@jonesday.com<br> abeck@jonesday.com<br> * <em>Pro hac vice application forthcoming</em></p> </div> </div> <p><em>Counsel for Plaintiffs</em></p> </div> <div class="col-md-4"> <div class="external-link spacer"><a class="btn btn-wide btn-primary" href="/legal-documents/2023-11-02-case-complaint-aha-tha-thr-united-health-care-system-v-rainer" target="_blank" title="Click here to download the Case Complaint: AHA, THA, THR, United Health Care System v. Rainer PDF.">Download the Case Complaint PDF</a></div> <div class="panel module-typeC"> <div class="panel-heading"> <h3 class="panel-title">Related Resources</h3> </div> <div class="panel-body"> <ul> <li><a href="/legal-documents/2023-11-02-lawsuit-challenges-federal-rule-ties-providers-hands-efforts-reach-their-communities">Lawsuit Overview</a></li> <li><a href="/press-releases/2023-11-02-hospital-associations-and-hospitals-file-lawsuit-challenging-federal-rule-ties-providers-hands-their">Press Release</a></li> <li><a href="/special-bulletin/2023-11-02-hospital-associations-and-hospitals-file-lawsuit-challenging-federal-rule-ties-providers-hands">Special Bulletin</a></li> <li><a href="/legal-documents/2023-11-02-case-complaint-aha-tha-thr-united-health-care-system-v-rainer">Case Complaint</a></li> <li><a href="/legal-documents/2023-11-02-case-explainer-american-hospital-association-v-rainer">Case Explainer</a></li> <li><a href="/frequently-asked-questions-faqs/2023-11-02-myth-vs-fact-hhs-ocr-online-tracking-rule">Myth vs. Fact Document</a></li> </ul> </div> </div> </div> </div> <div class="row"> <div class="col-md-8"> <h2>Introductions and Summary</h2> <p>1. The ���������� Association and the Texas Hospital Association (Associations), along with Texas Health Resources and United Regional Health Care System (Hospitals), bring this action because the federal government is threatening to enforce against hospitals and health systems a new rule that is flawed as a matter of law, deficient as a matter of administrative process, and harmful as a matter of policy. The rule, promulgated by the U.S. Department of Health and Human Services (HHS), prohibits the use of certain technologies that make healthcare providers’ public webpages more effective in sharing vital information with the community. Yet even as HHS is actively enforcing this new rule against hospitals across the country, the federal government’s own healthcare providers continue to use these purportedly prohibited technologies on their websites. A gross overreach by the federal bureaucracy, imposed without any input from the public or the healthcare providers most impacted by it, the HHS rule exceeds the government’s statutory and constitutional authority, fails to satisfy the requirements for agency rulemaking, and harms the very people it purports to protect. The Court should bar the rule’s enforcement.</p> <p>2. The Health Insurance Portability and Accountability Act of 1996 (HIPAA) and its implementing regulations “strike[] a balance.” <em>Summary of the HIPAA Privacy Rule,</em> U.S. Dep’t of Health & Hum. Servs, https://perma.cc/MCG3-QFHX. The law “protect[s] the privacy of people who seek care and healing,” while “permit[ting] important uses of information.” <em>Id.; see id.</em> (“A major goal of the Privacy Rule is to assure that individuals’ health information is properly protected while allowing the flow of health information needed to provide and promote high quality health care and to protect the public’s health and well being.”).</p> <p>3. Hospitals and health systems have long honored the balance HIPAA strikes. They take seriously their obligation to safeguard the privacy of patient records and billing statements. At the same time, they have embraced the federal government’s support for sharing non-private health-related information on their publicly accessible webpages that neither require nor request patients to enter login information for user authentication (an Unauthenticated Public Webpage).</p> <p>4. Now more than ever, the federal government has called on hospitals and health systems to combat “[h]ealth misinformation”—something the U.S. Surgeon General recently described as a “serious threat to public health.” V. Murthy, <em>Confronting Health Misinformation</em> (2021), https://perma.cc/YD2V-4QJE. While always working to protect private patient information, hospitals and health systems are keenly aware of their obligation to fulfill the other side of the HIPAA balance by “shar[ing] accurate health information with the public.” <em>Id.; see generally Understanding Some of HIPAA’s Permitted Uses and Disclosures,</em> U.S. Dep’t of Health & Hum. Servs, https://perma.cc/N7FC-DTW8 (“Information is essential fuel for the engine of health care. Physicians, medical professionals, hospitals and other clinical institutions generate, use and share it to provide good care to individuals, to evaluate the quality of care they are providing, and to assure they receive proper payment from health plans.… The capability for relevant players in the health care system – including the patient – to be able to quickly and easily access needed information to make decisions, and to provide the right care at the right time, is fundamental to achieving the goals of health reform.”).</p> <p>5. As part of these information-sharing efforts, many hospitals and health systems use third-party technologies to enhance their websites, including in the following ways:</p> <ul> <li><strong>Analytics tools</strong> convert web users’ interactions with hospital webpages into critical data, such as the level and concentrations of community concern on particular medical questions, or the areas of a hospital website on which people have trouble navigating. Website data analytics can tell a hospital how many IP addresses in the past month looked for information about, say, RSV vaccines or diabetes treatment in a particular area, which in turn allows hospitals to more effectively allocate their medical and other resources. These tools also help hospitals ensure that their public-facing webpages are user-friendly, helping community members to more easily navigate to healthcare information so that they can better manage their healthcare. For instance, hospitals can improve the functionality of their websites’ design so that they deliver a maximally seamless experience for individuals with disabilities, facilitating compliance with the Americans With Disabilities Act.</li> <li><strong>Video technologies</strong> allow hospitals to offer a wide range of information to the public, including videos that educate the community about particular health conditions and that allow visitors to virtually tour the facilities where particular procedures are performed.</li> <li><strong>Translation technologies</strong> help non-English speakers access vital healthcare information on hospitals’ webpages.</li> <li><strong>Map and location technologies</strong> provide better information about where healthcare services are available, including embedded applications that provide bus schedules or driving directions to and from a community member’s location.</li> </ul> <p>6. Third-party technologies like these, which typically rely on a visitor’s IP address to function, enable hospitals and health systems to hone their websites’ functionality and the helpfulness of their information. Just as crucially, these technologies allow hospitals and health systems to adjust and publicize information and services in response to public need and thereby improve public health, all without compromising the HIPAA balance.</p> <p>7. In December 2022, however, the Office for Civil Rights (OCR) in HHS precipitously upended the balance that HIPAA and its regulations strike between privacy and information-sharing. Without consulting healthcare providers, third-party technology vendors, or the public at large, the agency issued a sub-regulatory guidance document that has had profound effects on hospitals, health systems, and the communities they serve. <em>See Use of Online Tracking Technologies by HIPAA Covered Entities and Business Associates</em> (Bulletin), https://perma.cc/58V6-NTMG.</p> <p>8. In that bolt-from-the-blue “Bulletin,” OCR took the position that when an online technology connects (1) an individual’s IP address with (2) a visit to an Unauthenticated Public Webpage that addresses specific health conditions or healthcare providers, that combination of information (the Proscribed Combination) is subject to restrictions on use and disclosure under HIPAA. For example, if a public-health researcher used her personal computer to search a hospital’s webpage for the availability of dialysis appointments, the technology’s combination of (1) the researcher’s IP address and (2) the visit to a page addressing dialysis appointments would, according to the Bulletin, be subject to HIPAA’s requirements. So too if the technology combined (1) the IP address of an individual who used his personal computer on behalf of an elderly neighbor (2) to read a hospital’s webpage with information about the onset of Alzheimer’s disease.</p> <p>9. Remarkably, it appears that OCR issued the Bulletin without even consulting the federal government’s own website operators, because agencies that are covered entities under HIPAA themselves use the same third-party technologies on their webpages and create the Proscribed Combination. As one of many possible examples, web browser inspection and source tools show that, among other technologies, third-party analytics and advertising tools are present on Veterans Health Administration webpages addressing specific health conditions and healthcare providers, including but not limited to a page describing the symptoms of post-traumatic stress disorder and pointing veterans to treatment resources:</p> <p><img alt="U.S. Department of Veterans Affairs website screencap with red boxes added for emphasis." data-entity-type="file" data-entity-uuid="6e2c6f6d-cbaa-4e01-85eb-274800da9201" src="/sites/default/files/inline-images/US-Department-of-Veterans-Affairs-website-screencap-with-red-highlights_0.png" width="796" height="522"></p> <p><em>See, e.g., Mental Health,</em> U.S. Dep’t of Veterans Affairs, mentalhealth.va.gov/ptsd/index.asp (last visited Oct. 31, 2023) (red boxes added for emphasis).</p> <p><strong><em><a href="/legal-documents/2023-11-02-case-complaint-aha-tha-thr-united-health-care-system-v-rainer">Read the entire case complaint.</a></em></strong></p> </div> <div class="col-md-4"> <p><a href="/legal-documents/2023-11-02-case-complaint-aha-tha-thr-united-health-care-system-v-rainer" target="_blank" title="Click here to download the Case Complaint: AHA, THA, THR, United Health Care System v. Rainer PDF."><img alt="Case Complaint: AHA, THA, THR, United Health Care System v. Rainer page 1." data-entity-type="file" data-entity-uuid="86e9eb85-58ab-4177-bd94-f32f75a79797" src="/sites/default/files/inline-images/Page-1-Case-Complaint-AHA-THA-THR-United-Health-Care-System-v-Rainer.png" width="695" height="900"></a></p> </div> </div> </div> Thu, 02 Nov 2023 10:01:13 -0500 Legal Documents /legal-documents/2023-11-02-case-explainer-american-hospital-association-v-rainer <div class="container"> <div class="row"> <div class="col-md-8"> <h2><span>What is this case about?</span></h2> <p><em>���������� Association (AHA) v. Rainer</em> concerns a new rule from the Department of Health and Human Services (HHS) Office for Civil Rights (OCR) that severely restricts hospitals’ ability to rely on common third-party technologies that they use to analyze their websites and communicate reliable, accurate health information to the communities they serve. A massive overreach by the federal bureaucracy, the HHS rule exceeds the government’s statutory and constitutional authority, fails to satisfy the requirements for agency rulemaking, and harms the very people it purports to protect.</p> </div> <div class="col-md-4"> <div class="external-link spacer"><a class="btn btn-wide btn-primary" href="/system/files/media/file/2023/11/Case-Explainer-American-Hospital-Association-v-Rainer.pdf" target="_blank" title="Click here to download the Case Explainer: ���������� Association v. Rainer PDF.">Download the Case Explainer PDF</a></div> </div> </div> <div class="row"> <div class="col-md-8"> <p>Without soliciting input or feedback from the public or health care providers, and without following legally required notice-and-comment rulemaking processes, HHS-OCR issued this new rule in December 2022 and has since aggressively threatened regulatory enforcement and serious civil penalties against hospital systems and telehealth providers. The AHA, alongside the Texas Hospital Association, Texas Health Resources, and United Regional Health Care System, has filed a lawsuit in federal court seeking to enjoin the government’s enforcement of this new rule (known as the “Bulletin”).</p> <h2><span>What’s at stake?</span></h2> <p>The AHA, along with its co-plaintiffs in this case, allege that the OCR Bulletin is unlawful, harmful, and counterproductive. That new rule ties hospitals’ hands when it comes to using their websites to reach the communities they serve with important and truthful health information, and it upsets the careful balance that the Health Insurance Portability and Accountability Act of 1996 (HIPAA) — America’s primary health care privacy law — strikes between privacy-protection and information-sharing.</p> <p>Providers are now unable to use third-party technologies to enhance their websites and better reach members of their communities. Web tools that are ineffective because of the new rule include:</p> <div class="row"> <div class="col-md-2"> <p><img alt="Analytics software icon" data-entity-type="file" data-entity-uuid="d94eecc2-1698-4e1a-8392-ca1d38143b56" src="/sites/default/files/inline-images/analytics-software-icon.png" width="72" height="72" class="align-right"></p> </div> <div class="col-md-10"> <p><strong>Analytics software</strong> that converts interactions with hospital web pages into critical data, such as the level and concentration of community concern on particular medical questions or the areas of a hospital website on which people have trouble navigating.</p> </div> </div> <div class="row"> <div class="col-md-2"> <p><img alt="Video technologies icon" data-entity-type="file" data-entity-uuid="c99d2b86-1923-4d0f-a4bf-6bb3127657ca" src="/sites/default/files/inline-images/video-technologies-icon.png" width="72" height="72" class="align-right"></p> </div> <div class="col-md-10"> <p><strong>Video technologies</strong> that allow hospitals to offer a wide range of information and education materials to the public, including visuals that educate the community about particular health conditions and that allow visitors to virtually tour the facilities where particular procedures are performed.</p> </div> </div> <div class="row"> <div class="col-md-2"> <p><img alt="Translation and accessibility services icon" data-entity-type="file" data-entity-uuid="466059d6-72d8-42e1-b590-20405682a5ff" src="/sites/default/files/inline-images/translation-and-accessibility-service-icon.png" width="72" height="72" class="align-right"></p> </div> <div class="col-md-10"> <p><strong>Translation and accessibility services</strong> that help persons with limited English proficiency and people with disabilities access vital health care information on hospitals’ webpages.</p> </div> </div> <div class="row"> <div class="col-md-2"> <p><img alt="Digital maps icon" data-entity-type="file" data-entity-uuid="ef38859b-c02a-4e39-9532-f9a8d52711e2" src="/sites/default/files/inline-images/digital-maps-icon.png" width="72" height="72" class="align-right"></p> </div> <div class="col-md-10"> <p><strong>Digital maps</strong> that provide information about where health care services are available, including embedded applications that provide public transportation schedules or driving directions to and from a community member’s location.</p> </div> </div> <p>These third-party technologies are so essential that the federal government itself uses them for agency web pages that are covered entities under HIPAA — including HHS’ Medicare.gov, Tricare’s tricare.mil, and various Veterans Health Administration sites. For example, forensic tools indicate that the Veterans Health Administration uses analytics and advertising tools on a wide range of sites, including online resources describing the symptoms of post-traumatic stress disorder and pointing veterans to available treatment options.</p> <p><img alt="U. S. Department of Veterans Affairs website screenshot." data-entity-type="file" data-entity-uuid="904ca6f6-5383-4ad2-8594-7b7cb646209e" src="/sites/default/files/inline-images/US-Department-of-Veterans-Affairs-website-screencap-with-red-highlights.png" width="796" height="522"></p> <h2><span>Background and Case History</span></h2> <ul> <li><span><strong>Understanding OCR’s Bulletin:</strong></span> In December 2022, OCR released new guidance entitled <em>“Use of Online Tracking Technologies by HIPAA Covered Entities and Business Associates,”</em> which restricts hospitals from using third-party technologies that capture IP addresses on the portions of hospitals’ public-facing webpages that address health conditions or health care providers. Broadly treating IP addresses as protected information under HIPAA, this new rule subjects hospitals to enforcement actions and civil penalties under HIPAA if they do not comply with OCR’s new rule, forcing providers to strip their websites of these valuable technologies. OCR has since sent letters directly to hospitals threatening enforcement actions if they do not comply with the guidance, and OCR officials have publicly stated that they are conducting investigations into hospitals and health systems across the country to highlight its message.</li> <li><span><strong>Defining Private Health Data Under HIPAA:</strong></span> HIPAA prohibits health care providers from disclosing information that relates to a particular individual’s health, care, or payment for care, and that could reasonably be used to identify the same individual. OCR’s Bulletin provides no basis or evidence suggesting that an IP address’s web visit can be used to identify the individual whose health, care, or payment for care actually relates to the web visit. For example, someone may visit a hospital’s public-facing website to search for information on behalf of a family member, friend, or neighbor. Or that person may just have general curiosity about a health-related topic in the news. When she visits a hospital’s website and necessarily provides her IP-address—as all web visitors do—she is not disclosing private information within the statutory meaning of HIPAA. By reaching beyond the law to forbid hospitals from using these tools on public-facing webpages, OCR exceeded its statutory authority. In fact, one federal court in Illinois has already held that OCR’s rule “goes well beyond the meaning of what the [HIPAA] statute can bear.” <em>Kurowski v. Rush Sys. for Health,</em> 2023 WL 4707184, at *4 (N.D. Ill. July 24, 2023).</li> <li><span><strong>Legally Required Reasoning, Rulemaking Process:</strong></span> OCR unlawfully issued the Bulletin without providing any reasoning supporting its novel legal assertions or acknowledging the government’s own use of implicated third-party technologies by agencies that are covered entities under HIPAA. Further, prior to issuing its new rule, OCR did not consult hospitals and health systems about their use of online technologies or the impact that its new rule would have on potential patients or community members, and therefore it failed to follow the legally required notice-and-comment rulemaking process. The AHA sought to educate OCR about the widespread adverse impacts of this rule. After several months of outreach, the AHA was finally given an audience with OCR, but OCR refused to address any of the concerns raised by the AHA. Instead, OCR and the Federal Trade Commission sent letters to 130 hospitals (including Plaintiff Texas Health Resources) and telehealth providers threatening enforcement action, and later publicized the names of the letter-recipients on the agencies’ websites.</li> <li><span><strong>The AHA’s Objectives in Court: </strong></span>Through this lawsuit, the AHA is asking the district court to prevent OCR from enforcing this unlawful rule, so that the HIPAA balance is restored. More specifically, plaintiffs are seeking (1) declaratory judgment that IP addresses are not considered individually identifiable health information under statutory and regulatory definitions, (2) a permanent freeze on OCR’s enforcement of this rule, and (3) further relief that the court may deem just and proper — including, but not limited to, reasonable fees and costs.</li> </ul> <h2><span>About the ���������� Association</span></h2> <p>The ���������� Association (AHA) is a not-for-profit association of health care provider organizations and individuals that are committed to the health improvement of their communities. The AHA advocates 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. Founded in 1898, the AHA provides insight and education for health care leaders and is a source of information on health care issues and trends. For more information, visit the AHA website at <a href="/">www.aha.org</a>. For media inquiries, please contact the AHA’s Senior Vice President, Communications Alicia Mitchell: <a href="mailto:amitchell@aha.org?subject=Case Explainer: ���������� Association v. Rainer">amitchell@aha.org</a>.</p> </div> <div class="col-md-4"> <div class="panel module-typeC"> <div class="panel-heading"> <h3 class="panel-title">Related Resources</h3> </div> <div class="panel-body"> <ul> <li><a href="/legal-documents/2023-11-02-lawsuit-challenges-federal-rule-ties-providers-hands-efforts-reach-their-communities">Lawsuit Overview</a></li> <li><a href="/press-releases/2023-11-02-hospital-associations-and-hospitals-file-lawsuit-challenging-federal-rule-ties-providers-hands-their">Press Release</a></li> <li><a href="/special-bulletin/2023-11-02-hospital-associations-and-hospitals-file-lawsuit-challenging-federal-rule-ties-providers-hands">Special Bulletin</a></li> <li><a href="/legal-documents/2023-11-02-case-complaint-aha-tha-thr-united-health-care-system-v-rainer">Case Complaint</a></li> <li><a href="/legal-documents/2023-11-02-case-explainer-american-hospital-association-v-rainer">Case Explainer</a></li> <li><a href="/frequently-asked-questions-faqs/2023-11-02-myth-vs-fact-hhs-ocr-online-tracking-rule">Myth vs. Fact Document</a></li> </ul> </div> </div> <hr> <p><a href="/system/files/media/file/2023/11/Case-Explainer-American-Hospital-Association-v-Rainer.pdf" target="_blank" title="Click here to download the Case Explainer: ���������� Association v. Rainer PDF."><img alt="Case Explainer: ���������� Association v. Rainer page 1." data-entity-type="file" data-entity-uuid="90d74f86-b3f4-4390-aadb-246a64078d89" src="/sites/default/files/inline-images/Page-1-Case-Explainer-American-Hospital-Association-v-Rainer.png" width="695" height="900"></a></p> </div> </div> </div> Thu, 02 Nov 2023 06:00:00 -0500 Legal Documents /legal-documents/2023-11-02-lawsuit-challenges-federal-rule-ties-providers-hands-efforts-reach-their-communities <div class="container"> <div class="row"> <div class="col-md-8"> <p>The ���������� Association (AHA), joined by the Texas Hospital Association, Texas Health Resources, and United Regional Health Care System, today sued the federal government to bar enforcement of an unlawful, harmful, and counterproductive rule that has upended hospitals’ and health systems’ ability to share health care information with the communities they serve, analyze their own websites to enhance accessibility, and improve public health.</p> <p>“The Department of Health and Human Services’ new rule restricting the use of critical third-party technologies has real-world impacts on the public, who are now unable to access vital health information. In fact, these technologies are so essential that federal agencies themselves still use many of the same tools on their own webpages, including Medicare.gov, Tricare.mil, Health.mil, and various Veterans Health Administration sites. We cannot understand why HHS created this ‘rule for thee but not for me,’” said Rick Pollack, AHA President and CEO.</p> <p>Today’s lawsuit challenges a “Bulletin” issued by the U.S. Department of Health and Human Services (HHS) Office for Civil Rights (OCR) entitled, <em>“Use of Online Tracking Technologies by HIPAA Covered Entities and Business Associates.”</em> This December 2022 “Bulletin” restricts hospitals from using standard third-party web technologies that capture IP addresses on portions of hospitals’ public-facing webpages that address health conditions or health care providers. For example, under HHS’ new rule, if someone visited a hospital website on behalf of her elderly neighbor to learn more about Alzheimer’s disease, a hospital’s use of any third-party technology that captures an IP address from that visit would expose that hospital to federal enforcement actions and significant civil penalties.</p> <p>Hospitals and health systems have long honored the core objectives of the Health Insurance Portability and Accountability Act of 1996 (HIPAA), America’s primary health care privacy law. Congress enacted this law to strike a balance between protecting patients’ health information and ensuring the flow of information needed to provide communities with high quality care. The Bulletin, which HHS issued without consulting health care providers, third-party technology vendors, or the public at large, upsets HIPAA’s careful balance, preventing hospitals from using commonplace web technologies to analyze use of their websites and communicate effectively with the populations they serve.</p> <p>As alleged in the complaint, HHS’ Medicare.gov, the Department of Defense Military Health System and Defense Health Agency, and various U.S. Veterans Health Administration sites continue to use these third-party technologies despite being covered entities under HIPAA. For example, forensic tools revealed that the Veterans Health Administration uses analytics and advertising tools on a wide range of sites, including online resources that describe the symptoms of post-traumatic stress disorder and point veterans to available treatment options. While dozens of hospitals across the country have received enforcement threats, and hospitals are currently under active investigation by OCR, the federal government has not halted its own use of these vital tools.</p> <p>Web tools that are ineffective without access to IP-address information include analytics software, video technologies that offers the public education and information on health conditions, translation and accessibility services and digital maps among others.</p> <p>The suit alleges that HHS’ new rule exceeds its statutory authority under HIPAA. That statute allows hospitals to rely on third-party tools that capture IP address information because that information cannot reasonably be used to identify an individual whose health care relates to the webpage visit. By restricting use of these common tools on public-facing webpages on this basis, OCR violated HIPAA and has acted without legal authority. In addition, the suit alleges that OCR unlawfully issued this Bulletin without providing any reasoning supporting its novel legal assertions, without acknowledging the government’s own use of implicated third-party technologies, and without following required notice-and-comment rulemaking processes. Prior to issuing this rule, the federal government did not consult with hospitals and health systems about their use of third-party technologies that depend on the collection of IP addresses or the impact that its new rule would have on patients or communities. Instead, the agency began aggressively threatening regulatory enforcement and serious civil penalties against hospitals and health systems. After attempts to engage with HHS officials to educate them about the impact of their new rule, the AHA determined that it was necessary to file suit on behalf of its members to prevent the agency from unlawfully penalizing hospitals.</p> </div> <div class="col-md-4"> <div class="panel module-typeC"> <div class="panel-heading"> <h3 class="panel-title">Related Resources</h3> </div> <div class="panel-body"> <ul> <li><a href="/press-releases/2023-11-02-hospital-associations-and-hospitals-file-lawsuit-challenging-federal-rule-ties-providers-hands-their">Press Release</a></li> <li><a href="/special-bulletin/2023-11-02-hospital-associations-and-hospitals-file-lawsuit-challenging-federal-rule-ties-providers-hands">Special Bulletin</a></li> <li><a href="/legal-documents/2023-11-02-case-complaint-aha-tha-thr-united-health-care-system-v-rainer">Case Complaint</a></li> <li><a href="/legal-documents/2023-11-02-case-explainer-american-hospital-association-v-rainer">Case Explainer</a></li> <li><a href="/frequently-asked-questions-faqs/2023-11-02-myth-vs-fact-hhs-ocr-online-tracking-rule">Myth vs. Fact Document</a></li> </ul> </div> </div> </div> </div> </div> Thu, 02 Nov 2023 06:00:00 -0500 Legal Documents