AHA, hospitals ask court to compel HHS to comply with mandatory deadlines

The Department of Health and Human Services’ failure to meet the statutory deadlines for administrative review of claim denials at the Administrative Law Judge level violate the law and, if left uncorrected, threaten harm to health and welfare, the AHA and three hospital members said in an opening brief filed today in their appeal of a federal district court’s dismissal of their request for mandamus relief. “Indeed, the District Court acknowledged as much,” the brief states. “It cannot be an answer, once a court has found both a statutory violation and consequences to health and welfare, for the government simply to point to competing budget priorities in order to neutralize a mandamus request.” While sympathizing with hospitals that wait years for resolution of appeals, the federal district court for the District of Columbia said in its December 2014 dismissal order that “the waiting game must go on” for now because the delay in processing appeals is not so egregious as to warrant judicial intervention. The appeal is AHA v. Burwell (No. 15-5015) in the U.S. Court of Appeals for the D.C. Circuit.