After the Health and Resource Service Administration (HRSA) issued a December Advisory Opinion requiring 340B discounts for drugs dispensed through contract pharmacies, four drug manufacturers—Eli Lilly, AstraZeneca, Sanofi, and Novo Nordisk—have now filed four separate lawsuits in three jurisdictions challenging […]
On December 2, 2019, the Texas Health and Human Services Commission filed suit against HHS seeking reversal of an August 2018 DAB decision that upheld a $25 million disallowance against the state. The complaint, filed in D.C District Court, argues […]
Federal district courts in Washington, New York, and California have blocked the Trump Administration’s public charge rule from going into effect. The Southern District of New York’s ruling applies on a nationwide basis, with the other two rulings limited to the […]
On September 18, 2019, the D.C. District Court ruled that CMS exceeded its authority when it extended site-neutral payment to certain services in grandfathered clinics. The policy, issued as part of the November 2018 Outpatient Prospective Payment System (OPPS) Final […]
Over the last several years, courts in various jurisdictions have issued rulings in lawsuits challenging the Centers for Medicare & Medicaid Services’ (CMS’) policy requiring the inclusion of Medicare and commercial payments in the calculation of the Medicaid disproportionate share […]
On August 13, 2019, the D.C. Circuit issued its highly-anticipated decision in a lawsuit brought by the Children’s Hospital Association of Texas (CHAT) and others, challenging the legality of CMS’ 2017 Medicaid DSH third-party payer final rule that was set […]
As of December 30, 2018, CMS has withdrawn its policy on the inclusion of third party payments in calculating the disproportionate share hospital (DSH) limit. FAQs 33 & 34 require that states include commercial and Medicare payments, respectively, in their DSH limit […]
On December 27, 2018, the United States District Court for the District of Columbia granted plaintiff hospitals’ motion to permanently enjoin HHS’ nearly 30% cut to certain 340B drugs. The Court held that in implementing its Medicare Part B rate reduction, the […]
On November 14, 2018, in a 2-1 decision, the 6th Circuit affirmed a summary judgment ruling that CMS Medicaid DSH third party payer FAQs are procedurally invalid, while holding that CMS has the statutory authority to require the inclusion of Medicare and commercial […]
On September 27, 2018, the Supreme Court granted certiorari in Azar v. Allina Health Services, et al. The Court will hear arguments on whether HHS was required to go through notice and comment before implementing a rule that altered the Medicare reimbursement formula for […]
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