Department of Justice

DOJ will not attempt to block new challenges to ACA

Posted on November 1, 2012

The Department of Justice (DOJ) told the Supreme Court yesterday that they would not attempt to block requests to reopen a lawsuit against the Affordable Care Act (ACA). Such a lawsuit could potentially place the ACA in front of the Supreme Court again as early as next year.

In 2010, Liberty University sued over the minimum coverage provision and other aspects of the ACA, but the case was set aside when the 26 states and NFIB case went before the Supreme Court. Because the court upheld the constitutionality of the individual mandate in its June 28th decision, it essentially tossed out Liberty’s lawsuit. Liberty now wants the Supreme Court to review its other challenges to the ACA.

Specifically, Liberty claims that the law’s employer coverage requirements are unconstitutional, as the mandate’s contraception coverage requirement violates the right to freely exercise religion. Over 30 such claims have been filed against the Obama administration. Solicitor General Donald Verrilli’s letter to the court states that although the DOJ believes that the Liberty claims “lack merit,” the DOJ does not oppose the courts reviewing the suit.

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Supreme Court hears Anti-Injunction Act oral argument

Posted on March 26, 2012

From 10:12-11:41 am on March 26, 2012, the Supreme Court Justices heard the Anti-Injunction Act oral argument in Case Number 11-398, Department of Health and Human Services v. Flordia. Robert A. Long, the court-appointed amicus curiae opened the session, followed by Donald B. Verrilli on behalf of the petitioners. Gregory G. Katsas argued on behalf of the respondents and Mr. Long closed the session with a rebuttal argument. The Anti-Injunction Act is an 1867 federal law that bars suit “for the purpose of restraining the assessment or collection of any tax.” If the Supreme Court finds that the 1867 law does apply, a decision would be deferred until 2015, when Americans will first be penalized if they do not have health insurance.

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CMS releases ACO final rule, others agencies weigh-in

Posted on October 20, 2011

The Centers for Medicare and Medicaid Services (CMS) released the much anticipated Accountable Care Organization (ACO) final rule, implementing section 3022 of the Affordable Care Act (ACA), which contains provisions relating to Medicare payments to providers of services and suppliers participating in ACOs under the Medicare Shared Savings Program. The rule on Medicare ACOs relaxes eligibility requirements for doctors and hospitals to participate by halving the number of performance measurements (65 to 33), removing the electronic medical records (EMR) requirement, and eliminating some financial risks. CMS also extended the deadline for ACO applications through 2012. As enticement to rural doctors and physician-owned practices, CMS said it would dedicate $170 million to said providers to start ACOs. Regulators estimate that between 50 and 270 ACOs will be established in the next 3 years, which will affect the care of 4% of Medicare beneficiaries.

Multiple federal agencies also released rules and guidance on fraud & abuse and antitrust issues related to ACOs. The HHS Office of Inspector General (OIG) issued an interim final rule (IFR) on the waiver of certain fraud and abuse provisions and the Department of Justice (DOJ) issued a statement on health care antitrust enforcement policies.

To read more about ACOs, click here.

For the ACO final rule fact sheet, click here.

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DOJ/FTC issue joint policy statement on ACO antitrust enforcement

Posted on March 31, 2011

The U.S. Department of Justice (DOJ) and the Federal Trade Commission (FTC) have issued a joint policy statement on how they will enforce U.S. antitrust law related to the new Accountable Care Organizations (ACO) created by the Affordable Care Act (ACA). The two agencies are soliciting public comment on the proposed policy statement, which would create an antitrust “safety zone” and provide expedited antitrust review for certain ACOs.

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HHS/DOJ issue annual report on fraud and abuse

Posted on January 25, 2011

The U.S. Department of Health and Human Services (HHS) and the U.S. Department of Justice (DOJ) have issued their annual report on health care fraud and abuse. The report shows that the Federal Government’s Health Care Fraud and Abuse Control Program recovered more than $4 billion of taxpayer dollars during fiscal year 2010. HHS Secretary Kathleen Sebelius said, “Thanks to the President’s leadership and the new tools provided by the Affordable Care Act, we can focus on stopping fraud before it happens.”

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HHS and DOJ send letter to combat Medicare fraud

Posted on June 8, 2010

Health and Human Services Secretary Kathleen Sebelius and Attorney General Eric Holder have sent a letter to state attorneys general on new efforts to combat Medicare fraud. The letter is timed to coincide with the mailing of the $250 “donut hole rebate checks” authorized by the health reform law and pledges to “use the new tools and resources provided by the Affordable Care Act to further crack down on fraud.”

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HHS & DOJ highlight new anti-fraud provisions in health reform law

Posted on May 13, 2010

Releasing an annual report on health care fraud prevention, the Department of Health and Human Services and the Department of Justice emphasize new measures of the health reform law designed to route out abuse of the system.

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Justice Department responds to health reform lawsuit

Posted on May 13, 2010

The Department of Justice says the claim the government does not have the authority to require individuals buy health insurance is “flatly wrong” in a response to a suit brought by the Thomas More Law Center in the Eastern District of Michigan. This is separate from the lawsuit brought by several state attorneys general.

Justice Department Response

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