Though the American Hospital Association added its weight to a lawsuit filed against HHS last week, the organization continues to wield legal action sparingly compared with a more litigious stance with Washington in decades past.
Tom Nickels , the AHAs senior vice president of federal relations, said the association turns to the courts only when other avenues break down. In last weeks action, the AHA allied with the National Association of Public Hospitals and Health Systems and others to stop a Medicaid rule they believe would unfairly harm safety net hospitals. Last year when we were concerned with these regulations, we got Congress to stop them; we didnt need the courts to seek redress, Nickels said. We believe Congress has been very clear, and we want to utilize every remedy available to us to prevent this regulation from being implemented.
In the 1980s, the associations lawsuits against the government included challenges to the so-called Baby Doe regulations regarding treatment of infants with severe birth defects (which the U.S. Supreme Court decided against the government); the creation of peer-review organizations, or PROs; the obligation of hospitals to bear the costs of copying and sending records to PROs; and collective bargaining rules for hospital workers (which the Supreme Court decided in the governments favor).
A single 1990s case challenged the standing of HHS and the U.S. Justice Department to question Medicare claims for outpatient laboratory tests, which was dismissed on jurisdictional grounds. In 2002, the AHA joined the same partners involved in the new lawsuit in a losing bid to stop a previous rule change that limited the latitude for states to prop up public hospitals with enhanced Medicaid payments.
Even when the AHA isnt directly pursuing its interests through the courts, however, the organization persistently makes its legal positions clear through friend-of-the-court briefs, including arguments submitted to the Supreme Court in the past year involving whistle-blower complaints and hospital peer review.