/ en Sun, 27 Apr 2025 02:09:20 -0500 Thu, 01 Nov 18 12:06:36 -0500 /legal-documents/2018-11-01-alj-delay-lawsuit-remedy-opinion-and-order <h4><a href="/system/files/2018-11/181101-aljdelay-remedyopinion.pdf">Memorandum Opinion</a></h4> <p>This case is now before the Court for a third time, following a second remand from the D.C. Circuit. Plaintiffs here are the şÚÁĎŐýÄÜÁż Association and three other regional hospitals and health-care systems. Fed up by the delays in the administrative-appeals process for Medicare-reimbursement claims, they filed this suit in May 2014. Plaintiffs sought mandamus to compel the Secretary of the Department of Health and Human Services to comply with the statutory deadlines the Medicare Act imposes on the appeals process. See ECF No. 1 (Complaint). The Circuit initially instructed this Court to weigh the equities to determine whether mandamus should issue. After it did so and concluded that the writ was appropriate, the Circuit reversed and remanded the matter for this Court to make a threshold determination of whether it was possible for the Government to comply with the mandamus order. See Am. Hosp. Ass’n v. Price (AHA V), 867 F.3d 160, 161 n.1 (D.C. Cir. 2017). As this time around the Government agrees that recent funding has made compliance possible within four years, the Court will impose such a deadline.</p> <h4><a href="/system/files/2018-11/181101-aljdelay-remedyorder.pdf">Order</a></h4> <p>For the reasons set forth in the accompanying Memorandum Opinion, the Court ORDERS that:</p> <p>1. Defendant’s Motion for Summary Judgment is DENIED;<br /> 2. Plaintiffs’ Cross-Motion for Summary Judgment is GRANTED;<br /> 3. Defendant must achieve the following reductions from the currently projected FY 2018 backlog of 426,594 appeals: a 19% reduction by the end of FY 2019; a 49% reduction by the end of FY 2020; a 75% reduction by the end of FY 2021; and elimination of the backlog by the end of FY 2022; and<br /> 4. Defendant must file status reports beginning on December 31, 2018, and continuing every quarter thereafter.</p> <p>IT IS SO ORDERED.</p> Thu, 01 Nov 2018 12:06:36 -0500 ALJ Mandamus Remand Deadline for Deciding Appeals (RAC) /legal-documents/2018-08-10-aha-hospitals-reply-governments-response-recommended-non-deadline <p>At this Court’s request following the March status conference, Plaintiffs went back to the drawing board and came up with nine non-deadline remedies that can make meaningful progress toward eliminating the backlog; prevent additional appeals from entering the backlog; even out settlement incentives; and give the Court a modest oversight role to ensure steady forward progress. Plaintiffs further explained why each remedy was lawful, possible, and tailored to address the Court’s concerns at the last hearing.</p> <p>The Department of Health and Human Services’s response can be summed up with a single word: No. HHS’s response rejects every single one of Plaintiffs’ proposals—except status reports—including proposals offered in direct response to the Court’s comments at the March conference.</p> <p>Download the full document below.</p> Fri, 10 Aug 2018 13:56:56 -0500 ALJ Mandamus Remand Deadline for Deciding Appeals (RAC) /legal-documents/2018-08-06-secretarys-remedy-response-brief <p>Defendants' Status Report and Response to Plaintiffs' Proposed Non-Deadline Remedies</p> <p>To begin, AHA’s proposals cannot be justified based on the current record, which has changed considerably since the Court last determined that mandamus relief was appropriate in December of 2016. Indeed, the circumstances of the case have changed dramatically following the Court’s last hearing in March of this year because Congress has since appropriated significant additional funding to the Office of Medicare Hearings and Appeals (“OMHA”) that will allow OMHA to hire numerous new ALJs and staff and more than double its current adjudication capacity. Given this appropriation, HHS is now able to project that, with a continuation of current funding levels, the Secretary will be able to eliminate the backlog entirely in FY 2022.</p> <hr /> <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> Mon, 06 Aug 2018 10:50:38 -0500 ALJ Mandamus Remand Deadline for Deciding Appeals (RAC) /legal-documents/2018-07-12-governments-reply-attempts-offer-more-justification-why-court-should <p>Defendant Alex M. Azar, in his official capacity as Secretary of Health and Human Services (“HHS”), respectfully submits this Reply in support of Defendant’s opposed motion to extend his time to respond to Plaintiffs’ proposed non-deadline remedies for the Medicare appeals backlog. See ECF. No. 83. In further support of that motion, Defendant states as follows.</p> <p>Read full document below.</p> Thu, 12 Jul 2018 14:23:39 -0500 ALJ Mandamus Remand Deadline for Deciding Appeals (RAC) /legal-documents/2018-07-02-aha-hospitals-oppose-secretary-motion-extension-time-reply <p>Plaintiffs oppose the Department of Health and Human Services’s (HHS) motion for a six-week extension to file its response to Plaintiffs’ remedy proposals. HHS asserts that the extension is necessary primarily to compile additional data from the end of the most recent fiscal quarter. But the Court stayed the case for 90 days precisely so that HHS could compile this information; an additional six weeks is uncalled for now. And HHS’s other proffered justifications do not warrant six weeks of additional delay in this already stale case.</p> <p>Read the <a href="/system/files/2018-07/180702-hospitals-oppose-sec-motion-for-extension.pdf">full document</a> below. </p> <p>Read the <a href="/system/files/2018-07/180702-govt-extension-motion.pdf">government's motion for extension</a>.</p> Thu, 05 Jul 2018 16:20:28 -0500 ALJ Mandamus Remand Deadline for Deciding Appeals (RAC) /legal-documents/2018-06-22-aha-hospitals-brief-outlining-non-deadline-remedies-address-appeals <h4><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></h4> <h4><a href="/system/files/2018-06/180622-aha-azar-plaintiffs-remedy-proposed-order.pdf">Proposed order on the remedies</a></h4> Fri, 22 Jun 2018 16:13:41 -0500 ALJ Mandamus Remand Deadline for Deciding Appeals (RAC) /legal-documents/2018-03-22-court-order-alj-delay-case-march-22-2018 <p>Court ORDERS that: 1) The case is STAYED until June 22, 2018; 2) By that date, Plaintiffs shall submit specific proposals (and reasons therefor) that they wish the Court to impose via mandamus and explain why current procedures are insufficient; 2) By July 6, 2018, the Government will respond, providing a status update on the progress of current reforms and contesting why the defense proposals are impossible or unhelpful; and 3) Plaintiffs may file a reply by July 13, 2018.</p> Thu, 22 Mar 2018 13:55:07 -0500 ALJ Mandamus Remand Deadline for Deciding Appeals (RAC) /legal-documents/2018-02-15-reply-brief-aha-hospitals-alj-backlog-mandamus-order <div class="body"> <p>AHA, Hospitals' lawsuit to require HHS to meet deadlines for deciding appeals.  </p> <p>Reply Memorandum in Support of AHA and Hospitals' Cross-Motion for Summary Judgment.</p> <p>Plaintiffs' summary-judgment motion granted.</p> </div> Thu, 15 Feb 2018 12:03:46 -0600 ALJ Mandamus Remand Deadline for Deciding Appeals (RAC)