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Chevron’s Demise—And What It Means for Healthcare and Life Sciences Companies

Since 1984, the “Chevron doctrine” had served as the bedrock of many regulatory actions by the U.S. Department of Health and Human Services (HHS) and other federal agencies. Under the doctrine, courts followed a two-step...more

EMTALA Abortion Question Set Up for Supreme Court Review

As we’ve discussed in previous alerts (here and here), after the Supreme Court’s Dobbs decision, which eliminated the federal constitutional right to abortion and returned the question of abortion regulation to the states,...more

CMS Issues Rule Implementing Medicaid Redetermination Policies

We’ve written recently about the process that states are undertaking to begin to wind down the Medicaid enrollment expansion that was necessitated by the enactment of the Families First Coronavirus Response Act in March of...more

Biden Administration Releases Draft Framework for Exercising Bayh-Dole March-in Rights Taking Into Account Drug Prices

On December 7, the White House announced “New Actions to Lower Health Care and Prescription Drug Costs by Promoting Competition,” which included “a proposed framework for agencies on the exercise of march-in rights on...more

District Court Invalidates 340B Patient Definition in Genesis Case, Raising Questions About Program Scope

On Friday, November 3, 2023, the U.S. District Court for the District of South Carolina issued a long-awaited decision in Genesis Health Care, Inc. v. Becerra—a case dating back to 2017 contesting HRSA’s definition of...more

State Medicaid Redeterminations Following the End of the COVID-19 Era Continuous Enrollment Requirem

At the onset of the COVID pandemic in March of 2020, Congress made an important policy decision: continued access to health coverage was crucial, especially because, at the time, it was uncertain how the economy would...more

Competing EMTALA Decisions Underscore Complexity of Post-Dobbs Legal Landscape

In eliminating the federal constitutional right to abortion, the United States Supreme Court’s July 24, 2022 decision, Dobbs v. Jackson Women’s Health Organization, returned the question of abortion regulation to the “people...more

Two Lawsuits on EMTALA’s Role in a Post-Dobbs World

Following the Supreme Court’s decision in Dobbs, one federal law, the Emergency Medical Treatment and Labor Act (EMTALA), has become a focal point in the Biden administration’s efforts to challenge state attempts to restrict...more

Medicaid’s Right of Recovery Against Legal Settlements

The United States Supreme Court recently answered an important question in Medicaid law:  can a state Medicaid plan recover funds from a legal settlement involving a Medicaid beneficiary to pay for that beneficiary’s future...more

Becerra v. Empire Health Foundation: Supreme Court Validates HHS Read of Medicare DSH Fraction Statute

June 27, 2022 Key Takeaways: Late last week, the Supreme Court released its opinion in Becerra v. Empire Health Foundation, a case that involves the complex but important question regarding how to calculate the Medicare and...more

Enforcing Medicaid’s Requirements in the Federal Courts

The Supreme Court has announced that it will consider a case next term that has the potential to upend several decades of jurisprudence involving the Medicaid program. It involves a complicated area of the law, and in writing...more

Enforcing Medicaid’s Guarantee of Access to Prescription Drugs

Over the years, we’ve written about the difficulties in challenging the entitlement to Medicaid in the federal courts. In light of a series of Supreme Court decisions dating back to 1990, the pathway for an aggrieved Medicaid...more

Justice Breyer’s Influence on America’s Health Care System

This week’s news that Justice Stephen Breyer would step down from the Supreme Court at the conclusion of the Court’s term definitely caught our attention here at the Medicaid and the Law Blog. Our view is that Justice Breyer...more

Supreme Court Will Hear Several Health Care Cases in 2022 Term

Recently, my colleague Regina DeSantis told you about the ongoing saga involving disputes between 340B contract pharmacies and pharmaceutical manufacturers.  We often write about the 340B program on our blog because of the...more

Revocation of the “Public Charge” Rule

Readers of our blog know that Haider, Alex and I have a longstanding interest in the intersection of health care law and immigration law. That’s important for our blog, especially because of the needs of the immigrant...more

New House of Representatives COVID Relief Bill Contains Multiple Medicaid Provisions

Here at the Medicaid and the Law Blog, we’ve spent the past couple of days going through the American Rescue Plan Act, legislation introduced in the U.S. House of Representatives last Friday that is the latest attempt by...more

The Availability of a Private Right of Action in Medicaid

A few years ago, we told you about the “ongoing saga” surrounding the ability of a Medicaid beneficiary or a provider of health care services to a Medicaid beneficiary to challenge a state Medicaid agency’s putative violation...more

Coverage of Routine Clinical Trial Costs Under the Medicaid Program

Right before the new year, we told you about some of the Medicaid-related provisions of the COVID relief package that was recently signed into law by President Trump. One provision of that law that we thought merited a...more

Collecting Overpayments from Medicaid Providers

Today we want to address a topic that many state Medicaid agencies will no doubt be thinking about in the coming months, as the COVID-caused pandemic continues to threaten state finances and Congress has somewhat tied states’...more

CMS Finalizes Changes to Medicaid Prescription Drug Rebate Program

Earlier this year, my colleague Ross Margulies and I told you about a new proposed rule issued by CMS that makes several changes to the Medicaid prescription drug rebate program, or the MDRP. Recently, CMS finalized the rule...more

Medicaid Provisions in COVID-19 Relief Package

Here at the Medicaid and the Law Blog, we spent part of our holiday break reading through the most recent COVID-19 relief package that was finally signed into law by President Trump amid a not-insignificant amount of drama. ...more

2020 MACStats Released by MACPAC

On December 16, 2020, the Medicaid and CHIP Payment and Access Commission (MACPAC) released its annual MACStats: Medicaid and CHIP Data Book for 2020. This document contains a wealth of information about the Medicaid and CHIP...more

The Health Care Priorities of the Biden Harris Administration and Post Election Outlook for the 117th Congress

In a historic presidential election that began during the COVID-19 pandemic and ended with record voter turnout and mail-in ballots, former Vice President Joseph Biden of Delaware was declared the 46th president of the United...more

CMS Prevails in Litigation Challenging Pricing Policy for 340B Drugs

We’ve written before about the 340B program, which allows some health service providers that treat low-income patients to purchase outpatient prescription drugs at deeply discounted prices. It’s related (at least...more

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