News and Updates

SCOTUS Upholds Affordable Care Act in 7-2 Ruling

On June 17, 2021, the Supreme Court issued its long-anticipated decision in California v. Texas, upholding the Affordable Care Act once again in a 7-2 ruling. The Court did not reach the merits of whether the now $0 individual mandate penalty rendered the law...

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Manufacturers Respond to HRSA 340B Cease and Desist Letter

On June 10, 2021, Eli Lilly became the third manufacturer to response to HRSA’s May 17th Cease and Desist letter on 340B drug pricing. The response details Eli Lilly’s rejection of HRSA’s reasoning in its Cease and Desist letter, arguing that the agency’s reasoning is...

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Judge Enjoins 340B ADR Rule, But Only as Applied to Eli Lilly

A district court judge in Indiana today issued a narrow ruling enjoining the Department of Health and Human Services (HHS) from implementing a rule issued in December finalizing administrative dispute resolution (ADR) procedures for the 340B program. Eli Lilly argued...

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District Judge in California Dismisses Hospital 340B Lawsuit

A district court judge in California today dismissed a lawsuit filed by several hospital associations seeking to ensure enforcement of 340B discounts when drugs are dispensed through contract pharmacies. The judge concluded that the lawsuit was premature, as no final...

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CMS Approves 10-year Renewal of Texas 1115 Waiver

On January 15, 2021, CMS approved a 10-year renewal of Texas’ Section 1115 Medicaid waiver using emergency authority to bypass notice and comment requirements. The renewed waiver will extend and expand the state’s Uncompensated Care Pool and envisions the adoption of...

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CMS approves new 10-year TennCare III waiver

On January 8, 2021, CMS approved a new 10-year TennCare III waiver establishing a fixed aggregate dollar cap on funding accompanied by increased flexibility to make program changes and an opportunity for shared savings.

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CMS Releases New Guidance on Managed Care Directed Payments

On January 8, 2021, the Centers for Medicare & Medicaid Services (CMS) issued a State Medicaid Director Letter (SMDL) outlining additional guidance on Medicaid managed care directed payments, as well as a revised preprint form for use in seeking approval of...

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