HHS scores win in appeals fight

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Tuesday, August 15, 2017

NEW YORK – The D.C. Circuit on Aug. 11 ordered a federal judge to take a deeper look at whether or not the U.S. Department of Health and Human Services can clear a backlog of about 600,000 appeals by 2021, while still protecting taxpayer dollars, according to Law360. The ruling is a setback for the American Hospital Association, which has been fighting HHS in court over the backlog for several years. The D.C. Circuit, in a 2-1 ruling, said the judge didn’t properly evaluate HHS’s assertion that it could only clear the backlog by entering into mass settlements that would pay hospitals regardless of the merits of their appeals, something that would violate the agency’s legal duty to pay only legitimate claims, Law360 reports. The AHA first filed a lawsuit over the backlog in 2014 and since then the case has gone back and forth between the district and circuit courts. Most recently in January, the U.S. District Court for the District of Columbia stood its ground, with Judge James Broasberg refusing to rescind a previous order on Dec. 5 requiring the agency to eliminate the backlog by 2021.