Legal Resources: AHA Litigation

Escalating Claims Appeals  

AHA, Hospitals Sue to Require HHS to Meet Deadlines for Deciding Appeals  

Appeals court sends order to eliminate backlog of Medicare appeals back to trial court, August 11, 2017

Government's reply brief in the ALJ Delay Mandamus Appeal, April 6, 2017

AHA, Hospitals Reply Brief (and Statutory Addendum) in the Government’s appeal of the ALJ Delay mandamus order, March 23, 2017

Government's brief and Joint Appendix in their appeal of the ALJ delay mandamus order, Feb. 21, 2017

Court rejects government's request to reconsider court order compelling HHS to reduce the appeals backlog, Jan. 4, 2017

Opposition to government's motion for reconsideration, Dec. 21, 2016

AHA, Hospital reply brief, Nov. 15, 2016

Government's motion for stay DENIED, Sept. 19, 2016

Government’s reply brief, July 1, 2016

AHA, Hospitals Brief Opposing Stay June 13, 2016

Govt. Motion to Stay Proceedings on Remand, May 25, 2016

ALJ Delay Mandamus Appeal:  D.C. Circuit Court Reverses Lower Court's Decision, Feb. 9, 2016 

AHA, Hospitals reply brief in ALJ delay appeal, July 15, 2015

Government's reply brief in ALJ delay appeal, July 1, 2015

Government's request for extra time to file responsive brief in appeal granted, May 8, 2015

AHA, hospitals oppose request to extend time for government’s response, May 7, 2015

Opening appeal brief from AHA, hospitals, May 4, 2015

Court dismisses ALJ delay case, Dec. 18, 2014

Government's brief in support of its motion to dismiss, Oct 17, 2014

AHA, Hospitals brief opposing govt. motion to dismiss, further supporting our motion for summary judgment, Oct. 2, 2014

Government responds to AHA, Hospitals complaint and motion for summary judgment, Sept. 11, 2014

Briefing Schedule Set in ALJ Delay Litigation, Aug. 29, 2014 
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)

Parties Jointly Request Briefing Schedule, Aug. 29, 2014

Government's motion for extension of time to respond granted, 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)

AHA, Hospitals Oppose Government’s Request for Delay, July 22, 2014

DOJ Requests 45-Day Extension to Respond to ALJ Delay Lawsuit, July 21, 2014

AHA, Hospitals’ Motion for Summary Judgment ALJ Delay Lawsuit, July 11, 2014  

AHA, hospitals ask court to compel HHS to meet hearing deadlines, July 11, 2014

AHA, hospitals mandamus complaint to compel timely administrative review of Medicare claims denials, May 22, 2014 

AHA, Hospital Associations, Hospitals Sue HHS Over Two-midnight Inpatient Admissions Rule  

Two-Midnights and Other Requirements Complaint

Government’s responsive supplemental brief, February 29, 2016

AHA, associations, hospitals supplemental brief, February 1, 2016

AHA, Associations, Hospitals’ response to supplemental authority letter, October 22, 2014

Government's supplemental authority letter, October 20, 2014

Court decides to consider government’s motion to dismiss first, October 14, 2014

Government's brief supporting its motion to dismiss two-midnights litigation, September 4, 2014

AHA, Associations, Hospitals Oppose Government’s Motion to Stay Summary Judgment Briefing, August 18, 2014

Government’s Motion - Court should stay request for summary judgment to consider Government’s  motion to dismiss first, 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)

AHA, Hospital Associations, Hospitals Request Summary Judgment, Oppose Government’s Motion to Dismiss 2-Midnight Complaint, August 4, 2014

Government moves to dismiss AHA, Associations, Hospitals’ 2-midnights complaint, July 16, 2014

AHA, Hospital Associations, Hospitals Complaint Regarding Two-midnight Rule, April 14, 2014

0.2 Percent Offset Complaint

AHA comments on CMS's Dec. 1, 2015 Notice about 0.2 percent reduction to Hospital IPPS payments, February 2, 2016

Court orders remand for the .2% payment offset related to the 2-midnight policy, September 21, 2015

AHA, Athens Regional and Bakersfield Heart Plaintiffs' Proposed Reply Supporting Vacatur, August 31, 2015

Shands Jacksonville, St. Helena Plaintiffs’ Proposed Reply Supporting Vacatur, August 31, 2015

Government’s Reply Opposing Vacatur, August 31, 2015

Supplemental Brief from Hospital Plaintiffs related to Remedies in FFY 2014 .2% offset case, August 24, 2015

Government’s Supplemental Brief related to Remedies in FFY 2014 .2% offset case, 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)

Complaint challenging reduction in Medicare payment rates to hospitals for inpatient services in federal fiscal year (FFY) 2015, May 19, 2015

Government’s Reply Supporting its Cross-motion for Summary Judgment/Motion to Dismiss, November 21, 2014

AHA, Associations, Hospitals Reply Brief Opposing Government’s Motion to Dismiss/Cross-Motion for Summary Judgment, October 31, 2014

Government's response to our motion for summary judgment, October 15, 2014

AHA, Association, Hospitals Motion for Summary Judgment Refiled (per court order described below),  September 15, 2014

Court establishes briefing schedule in Consolidated 0.2 Percent Offset Cases, August 13, 2014
Upon consideration of [12], [13] the proposed scheduling orders, the parties are directed to comply with the following briefing schedule: plaintiffs' separate motions for summary judgment shall be filed by no later than September 15, 2014 and shall be limited to 30 pages each. The government's consolidated opposition shall be filed by no later than October 15, 2014 and shall be limited to 30 pages. If the government chooses to file a cross-motion, it shall be combined with the opposition, filed on the same date and limited to 30 pages, for a combined brief total of 60 pages. Plaintiffs' reply briefs and, if applicable, opposition briefs shall be filed no later than October 31, 2014 and shall be limited to 18 pages. The government's reply, if applicable, shall be filed no later than November 21, 2014 and shall be limited to 25 pages. Within one business day of each of the filings, the parties shall deliver to the chambers of the Honorable Emmet G. Sullivan two copies of their pleadings and exhibits. In connection with this scheduling order, plaintiffs Shands et al. and American Hospital Association et al. shall refile their motions for summary judgment. All pending motions for summary judgment, [10] plaintiffs' motion for summary judgment in Case No. 14-263 and [7] plaintiffs' motion for summary judgment in Case No. 14-607, are hereby DENIED without prejudice. The parties are advised that requests for extension of time will be viewed with extreme disfavor. Signed by Judge Emmet G. Sullivan on August 13, 2014. (lcegs4)

Judge consolidates AHA, Associations, Hospitals .2% cut cases with other pending .2% offset cases, July 23, 2014
MINUTE ORDER. The Court, sua sponte, consolidates this case (14-cv-263) with related cases Athens Regional Medical Center Inc. et al. v. Sebelius, Case No. 14-cv-503, American Hospital Association et al. v. Sebelius, Case No. 14-cv-607, and Bakersfield Heart Hospital et al. v. Burwell, Case No. 14-cv-976. See Fed. R. Civ. P. 42(a) (permitting the court to consolidate actions "involv[ing] a common question of law or fact"); Local Civ. R. 40.5(a)(3). The parties are directed to file all future documents in Case No. 14-cv-263. It is FURTHER ORDERED that the Clerk's Office is directed to close Case Nos. 14-cv-503, 14-cv-607 and 14-cv-976. It is FURTHER ORDERED that the defendant in Case No. 14-cv-976 shall file its response to the Complaint in that case by no later than August 15, 2014. Once the defendant has filed its response to that Complaint, the Court intends to institute a consolidated schedule for the briefing of dispositive motions. That schedule will proceed as follows: First, all plaintiffs that have not yet filed a motion for summary judgment will be directed to file their dispositive motions, if any. Second, the government will be directed to file a consolidated opposition to all pending motions for summary judgment, combined with any cross motion for summary judgment. Third, the plaintiffs will be ordered to file reply briefs, combined with their oppositions to the government's cross motion. Fourth, the government will file a consolidated reply in further support of its cross motion. To assist the Court in crafting an appropriate briefing schedule, the parties are hereby ORDERED to submit a joint status report containing proposed deadlines for this consolidated briefing schedule by no later than August 22, 2014. In the event that counsel are unable to agree on a joint recommendation, each party shall file an individual recommendation by that time. It is FURTHER ORDERED that briefing on all pending motions for summary judgment is hereby STAYED pending the institution of a briefing schedule by the Court. All pending motions requesting the institution of a briefing schedule, [7] joint motion for briefing schedule in Case No. 14-cv-503, [8] consent motion for briefing schedule and [11] motion for briefing schedule by plaintiffs in Case No. 14-cv-607, are hereby DENIED AS MOOT. Signed by Judge Emmet G. Sullivan on July 23, 2014. (lcegs4)

Motion for briefing schedule in the AHA, associations, hospitals' .2% offset case, July 14, 2014

Government answers AHA, Associations, Hospitals complaint about .2% offset, June 16, 2014

AHA, Associations, Hospitals Motion for Summary Judgment — 0.2 Percent Offset, May 23, 2014 

AHA, Hospital Associations, Hospitals Complaint Regarding .2% payment cut, April 14, 2014

First steps taken to challenge 2-midnight rule, AHA News Now, January 22, 2014

PRRB Appeal: .2 percent payment cut    

Judge dismisses rebilling complaint, September 17, 2014

Changes to rebilling policy do not affect AHA, Hospitals current legal challenge, March 7, 2014
The American Hospital Association, et al., v. Kathleen Sebelius
AHA and five hospital systems in a supplemental brief filed on Friday deny that their legal challenge to CMS’s rebilling policy is moot as a result of either temporary policy changes announced by CMS in a March 13, 2013 interim ruling or permanent revisions to the policy finalized in the FY 2014 IPPS rule.

Govt. Response to AHA, Hospitals’ March 7, 2014 Supplemental Brief

Govt. Supplemental Brief on Impact of Final CMS Rule, October 28, 2013

Plaintiffs’ Supplemental Brief on Impact of Final CMS Rule, October 28, 2013

The Plaintiffs' Opposition to Defendant's Motion to Dismiss, June 27, 2013
The American Hospital Association, et al., v. Kathleen Sebelius
The AHA and five hospital systems opposed the government’s attempt to dismiss the lawsuit filed last November against the Centers for Medicare & Medicaid Services.

Govt. Motion to Dismiss Complaint, June 6, 2013

Govt. Brief in Support of Its Motion to Dismiss Complaint, July 23, 2013 

Second Amended Complaint:  AHA, Hospitals Sue HHS on Part B Rebilling

Motion for Expedited Status Conference in RAC Rebilling Lawsuit

Proposed Motion for Summary Judgment in RAC Rebilling Lawsuit

Proposed Memorandum of Points and Authorities in Support of Motion for Summary Judgment

Declaration of Caroline Steinberg

Exhibit A to Proposed Motion for Summary Judgment

Exhibit B to Proposed Motion for Summary Judgment

Proposed Order

Amended Complaint: AHA, Hospital Systems Sue HHS

Complaint: AHA, Hospital Systems Sue HHS for Unfair Medicare Practices, AHA News Now, November 1, 2012
The AHA has filed suit against the U.S. Department of Health and Human Services (HHS) for refusing to meet its financial obligations for hospital services provided to some Medicare patients. The AHA was joined in the suit by four hospital systems in states including Michigan, Missouri and Pennsylvania. At issue is the administration's refusal to reimburse hospitals for reasonable and necessary care when the government in hindsight believes that such care could have been provided in an outpatient facility or department instead of in the inpatient portion of the hospital itself.  

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