The American Hospital Association (AHA) has appealed a United States District Court for the District of Columbia ruling that upheld the HHS transparency rule to the United States Court of Appeals for the District of Columbia. AHA isn’t alone in the appeal, which also includes a number of other association, lobbying, and health system entities. Further, a list of the amicus participants at the lower court is extensive. The AHA argues that the rule requiring disclosure of prices charged and amounts accepted from payors in return violates the First Amendment of the Constitution as compelled speech, and that the rule's stated statutory authority has been misconstrued. Although some would have thought the appellants would focus their arguments on the contract clause, as well as commercial interference, that doesn't seem to be the case. The outcome of this will be a huge issue for hospitals and health systems, managed care plans, and the managed care industry as a whole.