News & Analysis as of

Administrative Appeals Due Process

White & Case LLP

Taxpayer First Act and the Independent Office of Appeals

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The Taxpayer First Act of 2019 ("TFA")1 has passed both chambers of Congress and will likely soon be signed into law by the President. The bill has a wide range of provisions affecting and modernizing the Internal Revenue...more

Robinson+Cole RLUIPA Defense

Islamic Community Center Denied Variance Needed to Operate Mosque; Files Lawsuit Against Michigan City

Earlier this month, an Islamic community center filed suit against the City of Troy, Michigan (“City”) after the City denied the group’s application for a variance needed to operate a mosque at the property it owns in the...more

Flaster Greenberg PC

Can A Computer Deny My Medicaid Application?

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In the information age, computer programs are increasingly relied upon to streamline and facilitate important decisions. A number of states require online applications for Medicaid. In New Jersey and other states, Medicaid...more

Foley & Lardner LLP

CMS Recoupment Efforts Stopped by Court While Overpayment Appeals Are Pending

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Providers and suppliers who have been assessed overpayments for Medicare services are entitled, by statute, to a stay of recoupment while the provider or supplier’s appeal is pending – but only at the first two levels of...more

Jones Day

Texas Federal District Court Prevents Withholding of Medicare Payments

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In a much-anticipated decision in Family Rehab., Inc. v. Azar, Federal Judge Kinkeade enjoined the Centers for Medicare & Medicaid Services ("CMS") from withholding Medicare payments to effectuate the recoupment of the...more

Dechert LLP

Appellate Court Directs FTC to Be More Specific in its Data-Security Orders

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In a closely watched data-security case, the U.S. Court of Appeals for the Eleventh Circuit vacated as unenforceable a cease and desist order issued by the U.S. Federal Trade Commission (FTC) against LabMD, Inc. According to...more

Jones Day

Fifth Circuit Provides Relief for Providers Facing Medicare Appeal Backlogs

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The U.S. Court of Appeals for the Fifth Circuit has provided some relief to health care providers seeking to stop Medicare from "recouping" alleged overpayments before the provider can obtain a hearing before an...more

Baker Donelson

Court Finds Jurisdiction to Bar Recoupment Associated with Pending Claims Appeal

Baker Donelson on

On March 27, 2018, the United States Court of Appeals for the Fifth Circuit published an opinion that provides Family Rehabilitation, Inc. (Family Rehab) a second chance to postpone recoupment of about $7.6 million in...more

Arnall Golden Gregory LLP

Fifth Circuit: District Courts Have Jurisdiction to Halt Medicare Recoupments Pending Administrative Appeal to Prevent Procedural...

Medicare’s implementation of post-payment review through private contractors who are overly aggressive in denying payments, combined with an ineffective review process at the first two levels of administrative appeal...more

Williams Mullen

Legislative Efforts to Improve Due Process for the Medicaid Audit Appeal Process

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Responding to concerns raised by members of its Health Law Section, the Virginia Bar Association pursued budget language during the 2017 legislative session to address due process concerns with the manner in which the...more

Latham & Watkins LLP

A Favorable, New Climate for Challenging Medicare Appeals

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Over the past decade, health care providers seeking to challenge Medicare claim denials have faced increasing delays in reaching what many consider the most important step in the Medicare appeals process - a hearing before an...more

Farella Braun + Martel LLP

U.S. Supreme Court Issues Landmark Decision Authorizing Review of Wetland Jurisdictional Determinations

On May 31, 2016, the U.S. Supreme Court issued an eagerly anticipated decision that will benefit landowners and developers by authorizing immediate judicial review of Approved Jurisdictional Determinations (JDs) issued by the...more

K&L Gates LLP

D.C. Circuit Appears Poised to Overturn First CFPB Enforcement Action to Reach the Court: Five Key Takeaways From Yesterday’s Oral...

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Major financial firms almost never litigate with their regulators. As a result, regulators often take aggressive enforcement positions with little fear of judicial scrutiny. That’s been especially true for the Consumer...more

Baker Donelson

Proposed Enrollment Rule Changes - de Facto Exclusion?

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Proposed rules, touted as enhancing the provider enrollment process, would provide CMS with sanction authority that closely parallels the OIG’s exclusion authority. Under the proposed rules, CMS would have expanded bases to...more

Mintz - Intellectual Property Viewpoints

USPTO Implementation of AIA Does Not Violate Due Process: Federal Circuit Affirms the PTAB Panel Determining Institution of an IPR...

In Ethicon Endo-Surgery, Inc. v. Covidien LP, a 2-1 panel split of the Federal Circuit held that neither the American Invents Act (“AIA”) nor the Constitution precludes the same panel of the Patent Trial & Appeal Board...more

Arnall Golden Gregory LLP

AGG Helps Hospice Weather the Perfect Storm of Aggressive Medicare Payment Denials and Administrative Appeal Backlog

Medicare’s implementation of post-payment review through private contractors who are overly aggressive in denying payments, combined with a severe backlog of cases in queue for hearing before an Administrative Law Judge...more

Womble Bond Dickinson

Maine Supreme Court Looks Past City Planner's "Unprofessional" Plea to Zoning Board of Appeals

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This March, the Maine Supreme Judicial Court considered a claim that an "unprofessional" email from a city planner to the city's zoning board of appeals, pleading for a specific outcome on a land use appeal, does not per se...more

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