The AHA and Texas Hospital Association today filed a friend-of-the-court brief supporting the Texas Health and Human Services Commission and several Texas hospitals and health systems challenging a U.S. Department of Health and Human Services’ Departmental Appeals Board decision adopting a “net effect” standard for “bona fide provider-related donations” to supplemental payments in Medicaid. The Centers for Medicare & Medicaid Services adopted the standard in its Medicaid Fiscal Accountability Rule, withdrawn last September at the urging of AHA and others. 

“This regulatory history demonstrates that, one way or another, CMS impermissibly required regulated parties to operate in an unclear legal environment—and it unlawfully and retroactively penalized some of these regulated parties to the tune of $25 million for violating these unclear legal standards,” the brief states. “Put another way, the challenged DAB decision expected a state agency and the hospital-intervenors to conform its longstanding financing arrangements to a ‘net effect’ test that was not in place at the time and that the agency later indicated was unclear. This lack of clarity violates the most basic tenets of American law.” 
 

Related News Articles

Headline
The Government Accountability Office yesterday named five new members to the Medicaid and CHIP Payment and Access Commission, which advises Congress on…
Headline
A recent Health Affairs Blog post by physicians “gives an incomplete account of the implications of allowing new and expanded physician-owned hospitals to bill…
Blog
A recent Health Affairs post gives an incomplete account of the implications of allowing new and expanded physician-owned hospitals to bill Medicare and…
Headline
The Medicaid and Children’s Health Insurance Program Payment and Access Commission this week released its March report to Congress, which recommends…
Headline
The Centers for Medicare & Medicaid Services today released a request for applications for practices and payers to participate in the Primary Care First…
Headline
  The Biden administration has abandoned the prior administration’s defense of the public charge rule, dismissing appeals to the Supreme Court and…