Recently, the DC Court of Appeals determined that federal courts do in fact “have jurisdiction to decide the merits of a challenge to the federal government’s administration of the Protecting Access to Medicare Act (PAMA).”1 This ruling will result in the ACLA vs. Azar case being sent back to the DC District Court to determine if the decision from HHS/CMS to exclude hospital outreach labs from the first private payer payment survey, used to set Medicare CLFs rates for 2018-2020, was a violation of PAMA.2
In response to this appeal ruling, ACLA President, Julie Khani, issued the following statement:
“We strongly commend the Court of Appeals’ decision and are very encouraged that it recognizes that ACLA is entitled to challenge the harmful regulatory overreach by the HHS Secretary in his implementation of the Protecting Access to Medicare Act (PAMA). HHS’s continued flawed data collection process poses a direct challenge to the rule of law and PAMA’s intent to support a sustainable, market-based laboratory market for millions of seniors. On behalf of those who have already seen the consequences of this painful overreach, we urge the District Court to act quickly to rule on the merits of ACLA’s case.” 3
While this ruling can be viewed as a win for ACLA that will add pressure to HHS and CMS to negotiate for a settlement, it is likely that HHS will request a rehearing and push back the resolution of this lawsuit. In the meantime, ACLA urges Congress “to immediately halt the data reporting process and allow time to ensure that HHS is implementing PAMA in the right way.”3
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- Klipp, J. (2019, August). ACLA Wins Appeals Court Decision. Laboratory Economics: Competitive Market Analysis for Laboratory Management Decision Makers, 14(8),4.