Google Play App Store

Legal NewsNews Legal BlogsLaw Blogs Branding BlogsJudgements Branding BlogsBranding Blogs All Legal News and BlogsAll Blogs Legal JobsLaw Jobs

Recent Decision of Supreme Court on Azar v. Allina Health Services (17-1484) Recent Decision of Supreme Court on Azar v. Allina Health Services (17-1484)

Bronze medal Reporter Adv. John Posted 8 Jun 2019 Read More News and Blogs
Recent Decision of Supreme Court on Azar v. Allina Health Services (17-1484)

 

Title: Alex M. Azar, II, Secretary of Health and Human Services, Petitioner

v. Allina Health Services, et al.

Docketed:  April 30, 2018

Linked with 17A880    

Lower Ct:   United States Court of Appeals for the District of Columbia Circuit

Case Numbers:   (16-5255)

Decision Date: July 25, 2017

Rehearing Denied: November 29, 2017

 

Because the Department of Health and Human Services neglected its statutory notice-and-comment obligations when it revealed a new policy that dramatically—and retroactively—reduced Medicare payments to hospitals serving low-income patients, its policy must be vacated.

DECISION BELOW: 863 F.3d 937

LOWER COURT CASE NUMBER: 16-5255

QUESTION PRESENTED:

The Department of Health and Human Services (HHS) must utilize notice-and-comment rulemaking to promulgate rules, requirements, or statements of policy that "establish[] or change[]" a "substantive legal standard" governing payment for services under the Medicare Act, 42 U.S.C. 1395hh(a)(2). See 42 U.S.C. 1395hh(b)(l). The question presented is:

Whether Section 1395hh(a)(2) requires HHS to conduct notice-and-comment rulemaking before providing instructions to a Medicare Administrative Contractor that makes initial determinations of payments due under Medicare, when those instructions rest on a non-- legally-binding administrative interpretation of a relevant statutory provision.

LIMITED TO THE FOLLOWING QUESTION:

WHETHER 42 U.S.C. §1395hh(a)(2) or §1395hh(a)(4) REQUIRED THE DEPARTMENT OF HEALTH AND HUMAN SERVICES TO CONDUCT NOTICE-AND-COMMENT RULEMAKING BEFORE PROVIDING THE CHALLENGED INSTRUCTIONS TO A MEDICARE ADMINISTRATOR CONTRACTOR MAKING INITIAL DETERMINATIONS OF PAYMENTS DUE UNDER MEDICARE. JUSTICE KAVANAUGH IS RECUSED IN THIS CASE. CERT.

GRANTED 9/27/2018


CERTIORARI TO THE UNITED STATES COURT OF APPEALS FOR THE DISTRICT OF COLUMBIA CIRCUIT

No. 17–1484. Argued January 15, 2019—Decided June 3, 2019

 

The Medicare program offers additional payments to institutions that serve a “disproportionate number” of low-income patients. 42 U. S. C. §§1395ww(d)(5)(F)(i)(I). These payments are calculated in part using what is called a hospital’s “Medicare fraction.” The fraction’s denominator is the time the hospital spent caring for patients who were “entitled to benefits under” Medicare Part A, while the numerator is the time the hospital spent caring for Part-A-entitled patients who were also entitled to income support payments under the Social Security Act. §1395ww(d)(5)(F)(vi)(I). Congress created Medicare Part C in 1997, leading to the question whether Part C enrollees should be counted as “entitled to benefits under” Part A when calculating a hospital’s Medicare fraction. Respondents claim that, because Part C enrollees tend to be wealthier than Part A enrollees, counting them makes the fraction smaller and reduces hospitals’ payments considerably. In 2004, the agency overseeing Medicare issued a final rule declaring that it would count Part C patients, but that rule was later vacated after hospitals filed legal challenges. In 2013, it issued a new rule prospectively readopting the policy of counting Part C patients. In 2014, unable to rely on either the vacated 2004 rule or the prospective 2013 rule, the agency posted on its website the Medicare fractions for fiscal year 2012, noting that they included Part C patients. A group of hospitals, respondents here, sued. They claimed, among other things, that the government had violated the Medicare Act’s requirement to provide public notice and a 60-day comment period for any “rule, requirement, or other statement of policy . . . that establishes or changes a substantive legal standard governing . . . the payment for services,” §1395hh(a)(2). The court of appeals ultimately sided with the hospitals.



Click on the image to read more about AMENDMENT 5RIGHTS OF PERSONS WHEN PROPERTY IS TAKEN

 



Note:- We try our level best to avoid any kind of abusive content posted by users. Kindly report to us if you notice any, [email protected]

Copyright @ Pathmpor Consultants Pvt Ltd

F

r

e

e


A

d

v

i

c

e