News & Analysis as of

American Hospital Association

House Passes Bill Repealing Antitrust Immunity for Health Insurers

by King & Spalding on

Last week, the U.S. House of Representatives passed a bill that would end the limited Federal antitrust immunity for health insurers. The Competitive Health Insurance Reform Act of 2017 (H.R. 372) passed the House 416-7 and...more

HHS States that Agency Will Not Be Able to Meet Deadline to Clear Medicare Appeals Backlog

by King & Spalding on

In a status report filed on March 6, 2017, HHS revised projections regarding the Medicare appeals backlog, which make it unable to meet a court-imposed deadline to eliminate the backlog by 2020. The status report was filed in...more

HHS Report Acknowledges Complications of Fraud and Abuse Statutes on Value-Based Arrangements

by King & Spalding on

HHS posted a report to Congress on its website in August 2016 that responds to the requirements in the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) to offer legislative and regulatory suggestions regarding the...more

Potential Implications to the ACA Under the Incoming Republican Administration – Part III: Hospitals

President Trump has been clear in his intention to repeal the ACA. In fact, among President Trump’s first executive orders was one seeking to “minimize the economic burden” associated with the Patient Protection and...more

Judge Denies HHS’s Request to Rescind Timeline to Eliminate the Medicare Appeals Backlog

by King & Spalding on

On January 4, 2017, the court in the American Hospital Association (AHA) v. Burwell litigation denied HHS’s motion to reconsider, which means that HHS must comply with the court’s timeline to eliminate the Medicare appeals...more

The AHA’s Letter to Santa Claus

The American Hospital Association, after having been “nice” all year, penned its letter to Santa Claus with its wish list for Christmas. Its four page letter (actually addressed to President-Elect Donald Trump at 1717...more

U.S. District Court for District of Columbia Requires HHS to Eliminate Medicare Appeals Backlog by December 31, 2020

by Baker Ober Health Law on

On December 5, 2016, a U.S. District Court for the District of Columbia granted summary judgment in American Hospital Association, et al., v. Burwell, in favor of the American Hospital Association (AHA) in its quest to reduce...more

Court Orders HHS to Eliminate Medicare Appeals Backlog by Start of CY 2021

by King & Spalding on

As previously reported, the American Hospital Association (AHA) filed suit against HHS in 2014 in connection with the Medicare appeals backlog and requested that the court force HHS to meet its statutory deadline for...more

District Court Denies Stay in Litigation Over Medicare Appeals Backlog

by King & Spalding on

On September 19, 2016, the U.S. District Court for the District of Columbia rejected a request by HHS to stay proceedings in litigation brought by the American Hospital Association and several providers seeking to compel the...more

Also In The News - Health Headlines - July 2016 #2

by King & Spalding on

House Committee Approves Bill Providing Relief for Rural Hospitals – On July 7, 2016, the Ways and Means Committee for the House of Representatives voted unanimously to approve the Continuing Access to Hospitals Act, as...more

CMS Proposes to Limit Site Neutral Payment Exceptions Applicable to Certain Off-Campus Hospital Departments Following Relocation,...

On July 6, 2016, CMS released the 2017 Outpatient Prospective Payment System (OPPS) Proposed Rule which, among other things, implements Section 603 of the Bipartisan Budget Act of 2015. Despite extensive lobbying efforts by...more

American Hospital Association Urges IRS To Affirm that Tax-Exempt Hospitals Can Participate in Non-Medicare ACOs

by King & Spalding on

The American Hospital Association (AHA) has written to John Koskinen, Commissioner of the Internal Revenue Service (IRS), and Mark Mazur, Assistant Secretary for Tax Policy at the Treasury Department, raising concerns about...more

4 Key Things to Watch on Recent Finding Related to Medicare Appeals Backlog

by Polsinelli on

On Feb. 9, 2016, the D.C. Circuit found that the lower court has the authority to order the Department of Health & Human Services (HHS) to resolve the massive backlog of Medicare appeals tied up in the administrative law...more

HHS May Be Forced to Meet Statutory Deadlines for ALJ Appeals

by King & Spalding on

On February 9, 2016, a three-judge panel of the U.S. Court of Appeals for the District of Columbia Circuit reversed a district court’s dismissal for lack of jurisdiction in the American Hospital Association v. Burwell case. ...more

Congress Takes Long Look at Proposed Health Insurance Mergers

by Baker Donelson on

While the Department of Justice Antitrust Division is responsible for reviewing the proposed Anthem/Cigna and Aetna/Humana mergers for any potential competitive concerns, Congress jumped into the process with both feet in...more

House Ways & Means Health Subcommittee Hosts Hearing on Hospital Payment Issues

by King & Spalding on

On July 22, 2015, the U.S. House Ways & Means Health Subcommittee heard testimony from Mark Miller, Ph.D., executive director of Medicare Payment Advisory Commission (MedPAC). Dr. Miller’s testimony highlighted recent trends...more

CMS Call: Countdown to ICD-10 (Aug. 27)

by Reed Smith on

On August 27, 2015, CMS is hosting a call to help health care providers prepare for ICD-10 implementation on October 1, 2015. CMS staff will be joined by representatives of the American Health Information Management...more

Senate Aging Committee Hearing on Hospital Observation Stay Policies

by King & Spalding on

On May 20, 2015, the Senate Special Committee on Aging held a hearing entitled “Challenging the Status Quo: Solutions to the Hospital Observation Stay Crisis.” Chairman Susan Collins (R-ME) and Ranking Member Claire...more

American Hospital Association Releases Social Media Guide

by Robinson & Cole LLP on

On May 13, 2015, the American Hospital Association (AHA) issued “A Hospital Leadership Guide to Digital & Social Media Engagement.” The Guide is as hip as can be for the AHA, and provides easy to understand and practical tips...more

ABA Antitrust Spring Meeting Highlight: “Antitrust & Health Care: Square Peg in a Round Hole?”

by McDermott Will & Emery on

In this month’s American Bar Association (ABA) Section of Antitrust Law Spring Meeting, the program “Antitrust & Health Care: Square Peg in a Round Hole?” featured debate and discussion about antitrust law treatment of health...more

The Enemy of My Enemy Is My Friend

by Faegre Baker Daniels on

We don’t normally think of American Hospital Association and the Federation of American Hospitals as friends. After all, the AHA represents nonprofits, while the FAH represents for-profits. ...more

OIG Responds to Hospital Compliance Review Objections

by Reed Smith on

The OIG has defended its hospital compliance review policies in response to objections raised by the American Hospital Association (AHA). Specifically, a January 15, 2015 OIG letter addresses four main areas of AHA concern...more

ProMedica and the AHA Seek Guidance from SCOTUS on Hospital Consolidations and Mergers

by Cozen O'Connor on

The New Year started out with a bang in the healthcare antitrust circles with ProMedica Health Systems Inc.’s (“ProMedica”) well-publicized petition to the US Supreme Court and the American Hospital Association’s (AHA) amicus...more

Medicare Hospital Compliance Reviews are Legal and Sound, According to OIG

The Office of Inspector General for the Department of Health and Human Services (OIG) recently defended its practices pertaining to hospital compliance reviews in a published response to a letter from the American Hospital...more

No Judicial Relief to the ALJ Waiting Game — Yet

In May 2014, the American Hospital Association filed suit against the United States Department of Health and Human Services seeking to compel Administrative Law Judges (ALJs) to comply with applicable statutory deadlines for...more

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