The Courts

Less than 24 hours after the Department of Justice asked a federal court to throw out the entire Affordable Care Act, House Democrats introduced sweeping legislation to bolster the Obama-era health care law and rallied to protect the law as the case moves through the appeals system.

The federal government says cutting the pay rates for clinic visits at certain off-campus hospital outpatient facilities is well within CMS’ authority, and the law exempting those facilities from other site-neutral payments doesn’t limit CMS’ ability to change the pay rates for services to control volume.

The Department of Justice on Monday (March 25) told the Fifth Circuit Court of Appeals that it now agrees with District Judge Reed O ‘Connor’s Dec. 14 decision that the ACA’s individual mandate is no longer valid and therefore the entire Affordable Care Act, which included major reforms to the insurance market and Medicaid and established the biosimilars market, should be thrown out.

Wisconsin Attorney General Josh Kaul filed a motion telling federal courts in Texas that the state is no longer interested in the challenging the constitutionality of the Affordable Care Act and would like to be formally removed as a plaintiff in Texas v. Azar.

The class action lawsuit spearheaded by Wisconsin-based Common Ground Health Cooperative and involving about 90 other exchange issuers has filed an amended complaint with the Federal Court of Claims and now seeks to collect cost-sharing reduction reimbursements owed for plan years 2017, 2018 and 2019.

The Department of Justice is asking a federal court to dismiss a lawsuit brought by five major cities who charge the administration is violating the Constitution through its efforts to sabotage the Affordable Care Act.

The Depart of Justice immediately appealed a closely watched lawsuit worth potentially billions of dollars to dozens of insurers late Thursday (March 7) after a federal court formally ordered the government to pay Community Health Choices a total $71 million in cost-sharing reduction reimbursements for the 2017 and 2018 plan years.

The Department of Justice is asking the federal claims court to issue a final judgment of about $71 million in 2017 and 2018 cost-sharing reduction payments for Community Health Choice (CHC), in order to smooth the way for a quick appeal, but wants the court to wait until CMS completes the 2018 reconciliation process before entering a judgment for Maine Community Health Options (MCHO) and the class action suit led by Common Ground Health Co-Op.

The federal government has asked the federal D.C. district court to dismiss hospitals’ request to scrap lower reimbursement for 340B drugs in 2019 by pointing back to arguments it used to defend the agency’s initial 2018 cuts, which the court found were beyond CMS’ authority.