Health Reform WK-EDGE ACA, ADA claims against hospitals dismissed for failure to exhaust administrative remedies
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Tuesday, March 3, 2020

ACA, ADA claims against hospitals dismissed for failure to exhaust administrative remedies

By Elena Eyber, J.D.

A patient’s complaint against hospitals and doctors was dismissed for failure to exhaust administrative remedies required under the ACA and the ADA.

A federal district court in Pennsylvania dismissed a patient’s complaint against all hospitals and doctors for failure to exhaust administrative remedies. A patient in his eighties filed this action under Section 1557 of the Patient Protection and Affordable Care Act (ACA) (P.L. 111-148) and Age Discrimination Act of 1975 (ADA) following medical treatment he received at the hospitals from the doctors. The patient maintained that the level of care he received was not the same afforded to younger persons, and the discrimination he experienced was representative of a systemic problem within the hospitals. The hospitals and doctors moved to dismiss the complaint for lack of subject matter jurisdiction and for failure to state a claim, arguing that the patient failed to exhaust his administrative remedies. The court agreed and held that the patient failed to allege that he exhausted any of the administrative remedies required under the ACA and the ADA prior to filing the lawsuit (Papa v. Diamandi , February 13, 2020, Kenney, C.).

Administrative remedies. The court held that the patient failed to exhaust administrative remedies required under Section 1557 of the ACA and the ADA prior to filing the lawsuit. The court noted that the complainants are required to file an administrative complaint within 180 days from the date the complainant first had knowledge of the alleged act of discrimination and then they may file a civil action only after 180 days have elapsed since the complainant filed the administrative complaint and the reviewing agency has made a finding.

Further, the complainant must give 30 days’ notice by registered mail to HHS, the Attorney General, the head of the granting agency, and the grant recipient, which includes the alleged violation, the relief requested, the court in which that action will be brought, and any relief for attorney’s fees. The court found that the patient failed to allege that he exhausted or attempted to complete these administrative steps prior to filing this lawsuit. Accordingly, the court dismissed the patient’s complaint against all hospitals and doctors for his failure to exhaust and provide notice under the ACA and ADA.

The case is No. 19-846.

Attorneys: Rudolph F. Papa, pro se. Henry F. Siedzikowski (Elliott Greenleaf, PC) for Mihai Diamandi.

Cases: CaseDecisions AccessNews AgencyNews GeneralNews InpatientFacilityNews PhysicianNews PennsylvaniaNews NewsFeed

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