Published by the American Health Law Association
Written by Jim May, Tom Clarkson, and Jonathan A. Porter
This article is brought to you by AHLA’s Fraud and Abuse Practice Group
Over the last four decades, federal agencies have been free to implement laws with minimal checks by the courts, so long as those agencies’ implementing regulatory scheme is reasonable and not directly in violation of the enabling statutory structure. The judicial empowerment of federal agencies is perhaps most pronounced in the health care realm, where the Centers for Medicare and Medicaid Services (CMS) and Medicare Contractors have created an entire ecosystem of rules, advisory opinions, and guidance documents that far exceed the structure created by Congress to implement the federal government’s largest health care programs and can be changed at the whim of the agencies and contractors.