A Squire Patton Boggs team led by Stephen P. Nash and Sven Collins has scored another victory against the Department of Health and Human Services (HHS) and its self-disallowance regulation, which despite suffering two defeats in federal court, has not yet been invalidated or amended by the agency.
In an October 25 decision, Judge Amit P. Mehta of the US District Court for the District of Columbia ruled that the five hospitals that are challenging Medicare payment regulations do not have to return to the HHS Provider Reimbursement Review Board (PRRB) to continue their appeal. Citing the self-disallowance regulation, the hospitals are claiming the PRRB is unjustly denying them the right to litigate a collective amount of US$18.5 million.
Judge Mehta’s order keeps intact in re Banner Heart Hospital v. Burwell, a 2016 significant ruling won by this Squire Patton Boggs team. That said, although Judge Mehta’s opinion describes HHS’s actions since Banner Heart as “schizophrenic,” it stops short of declaring the regulation invalid for all providers without additional briefing from both parties. The parties are scheduled for a hearing before Judge Mehta on November 7, 2017.
The hospitals [Bayshore Community Hospital, Ocean Medical Center, Riverview Medical Center, Southern Ocean Medical Center and Jersey Shore University Medical Center] are represented by Mr. Nash, with Mr. Collins, Mimi Hu Brouillette, Michi Tsuda, Larisa Vaysman and Aditi Kulkarni.