February 05, 2021

Dialysis Facility Lawsuit Challenging Medicare Advantage Network Adequacy Rule Dismissed

A lawsuit challenging the new Medicare Advantage Organization network adequacy rules has failed. Several parties sued HHS, CMS, and their officials, challenging a final rule published in June 2020 that established network adequacy standards for Medicare Advantage Organizations (MAO). Among other things, the rule removed the “time and distance” requirements for dialysis facilities, and instead allowed a MAO to attest to their network adequacy for dialysis services. HHS and CMS argued that the legal challenge was not ripe, based on judicial principles of agency action and ripeness. The complaining parties failed to respond to the ripeness argument, and the court ruled that this failure to respond conceded the issue and dismissed the lawsuit.