AHA seeks emergency relief to block enforcement of price transparency rule

A CMS bulletin from last Friday led AHA to file the emergency request with the federal appeals court. The notice informed providers that CMS is prepared to “audit a sample of hospitals for compliance starting in January” and those providers found in violation will face civil monetary penalties.

AHA argues that halting the policy is necessary given the “exceptional circumstances” the industry faces. 

“This imminent enforcement regime will force overburdened hospitals to divert resources that hospitals desperately need to respond to the surge of COVID-19 cases and successfully roll out the vaccines that were approved following oral argument in this case,” the filing states.

It points to Saint Luke’s Health System in Kansas City, Missouri, and the hurdles it faces, saying the same technology staff members responsible for implementing the price transparency rule are also needed to build the platform to track COVID-19 vaccinations.

“The time and resources these employees devote to implementing are time and resources diverted from responding to the COVID-19 pandemic,” Charles Robb, CFO for Saint Luke’s said in a declaration provided to the court. Saint Luke’s operates 16 hospitals around Kansas City and in rural areas of Kansas and Missouri.

AHA noted that the government does not consent to its motion for stay, asking for intervention by Dec. 31.

Meanwhile, the hospital lobby is still waiting on the ruling from federal appeals court. But after listening to oral arguments back in October, industry experts don’t feel AHA will prevail in the case, which is seeking to knock down the law. 

The three-judge panel seemed highly skeptical that it is unlawful for the government to compel providers to publish the negotiated rates they reach with insurers for services provided to patients. 

Without any relief in sight, hospitals have already started preparing to come into compliance on Jan. 1. 

“People are really starting to move towards compliance. I think they realize that it’s here to stay,” Becky Greenfield, an associate attorney with Wolfe Pincavage, previously told Healthcare Dive.