A Washington DC federal judge dismissed a lawsuit on August 4 filed by the American Orthotic & Prosthetic Association (AOPA) against the U.S. Department of Health and Human Services (HHS), Medicare in May 2013. AOPA filed the suit to seek relief from what it called the unfair and unauthorized actions of the Centers for Medicare & Medicaid Services (CMS), primarily via actions of its Recovery Audit Contractor (RAC) auditors and Durable Medical Equipment Medicare Administrative Contractors (DME MACs) relating to physician documentation requirements. In an order granting the agency’s motion to dismiss, U.S. District Judge Royce C. Lamberth said AOPA’s claims were not redressible by judicial action, because the agency was exercising discretion it already possessed, and AOPA therefore lacked standing to sue.
Thomas F. Fise, JD, AOPA executive director, issued the following statement on the ruling:
“AOPA is disappointed with the decision of the district court, and is still weighing its options in terms of possible appeal. AOPA filed the lawsuit hoping to address the threat to the availability of prosthetic devices resulting from the abrupt August 2011 change in the federal government’s reimbursement rules. While the court dismissed AOPA’s suit on largely technical grounds, AOPA believes that the suit was necessary to stand firm for the principle that Medicare cannot take shortcuts with the proper administrative procedures when it is changing rules about what patients are entitled to and how it will determine payments. AOPA felt compelled to do anything that it could that might have helped avoid the over 100 business closings that have ensued, and secure fairness for our members, even knowing the road to success would likely be difficult. AOPA will continue to use all available tools, including advocacy in the legislative, regulatory, and judicial sectors to restore fairness for our member healthcare professionals and the Medicare amputees they serve.”
To read some commentary by critics of the decision, visit the AOPA website.
Editor’s note: This story was adapted from materials provided by Law360.com
