News & Analysis as of October 13, 2024

Reimbursements

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The United States Supreme Court is the highest court of the United States and is charged with interpreting federal law, including the United States Constitution. The Court's docket is largely discretionary with only a limited number of cases granted review each term. The Court is comprised of one chief justice and eight associate justices, who are nominated by the President and confirmed by the Senate to hold lifetime positions. less -

Post-Chevron Health Care Regulations: The Dawn of a New Day

ArentFox Schiff on 7/15/2024

On June 28, the US Supreme Court overturned the Chevron doctrine — the legal principle that the judiciary should defer to a federal agency’s reasonable interpretation of an ambiguous statute. Chevron reflected the view...more

Supreme Court Overturns Chevron in Landmark Decision with Broad Implications for Medicare Reimbursement Litigation

King & Spalding on 7/3/2024

On June 28, 2024, the Supreme Court issued a decision in Loper Bright Enterprises v. Raimondo that overturned the Chevron Doctrine, which requires courts to defer to agency interpretations of ambiguous statutes, thereby...more

What the Supreme Court's "Chevron Deference" Ruling Could Mean for Health Care Law

Baker Donelson on 6/26/2024

Baker Donelson recently published Anticipating SCOTUS Ruling on Chevron Deference – What to Know and Five Ways to Prepare explaining the United States Supreme Court's upcoming ruling which is expected to impact the regulatory...more

Supreme Court’s SuperValu Decision: a Game-Changer for Assessing FCA Violations

Ballard Spahr LLP on 6/20/2023

Summary - On June 1, 2023, the Supreme Court issued a landmark decision in False Claims Act cases. In United States ex rel. Schutte v. SuperValu Inc., it unanimously held that liability under the False Claims Act depends...more

Supreme Court FCA Decision and NLRB GC Memo on Non-Competes

Schwabe, Williamson & Wyatt PC on 6/9/2023

Two important decisions, one by the United States Supreme Court and one by the General Counsel for the National Labor Relations Board (“NLRB”), were issued this week and may be of interest to government contractors and...more

Investigations Newsletter: Supreme Court Again Tightens FCA Intent, But Tricky Questions Linger

ArentFox Schiff on 6/8/2023

The US Supreme Court brushed aside novel assertions from two pharmacy retailers on June 1 and ruled unanimously that False Claims Act liability hinges on whether defendants subjectively believed their claims were “false.” In...more

Supreme Court Clarifies FCA Scienter Standard – Overturns 7th Circuit Decision

Davis Wright Tremaine LLP on 6/6/2023

Ruling in case involving national retail pharmacies rejects the “objective reasonableness” standard for the False Claims Act - On June 1, 2023, the U.S. Supreme Court unanimously vacated the 7th Circuit's decision in U.S....more

High Court Hears Important Case on False Claims Act’s Scienter

WilmerHale on 5/9/2023

On April 18, the Supreme Court heard oral argument and what has been billed as the most important False Claims Act (FCA) case in a decade. Since the FCA was enacted in the Civil War era, it has been the primary tool for the...more

The Government’s Ability to Combat Fraud is on the Line in False Claims Act Supreme Court Case

Kohn, Kohn & Colapinto LLP on 4/17/2023

Oral arguments are scheduled for April 18, 2023, in the Supreme Court case combining two Seventh Circuit Court of Appeals cases U.S. ex rel. Schutte v. SuperValu, Inc. (“SuperValu”) and U.S. ex rel. Thomas Proctor v. Safeway,...more

Knowing IS the Battle: Supreme Court to Address the FCA’s Scienter Standard

McCarter & English Blog: Government Contracts... on 2/3/2023

Scenario 1: A pharmacy chain hires a value consultant to review its Medicare and Medicaid billing practices for ways to optimize the coding of drug reimbursements to maximize profits. Drugs that had historically been charged...more

CMS Reverses 340B Payment Cuts for 2023 but Does Not Address Remedy for Prior Years

Bass, Berry & Sims PLC on 11/14/2022

On November 3, the Centers for Medicare & Medicaid Services (CMS) issued an update to its Medicare Part B drug payment policy for hospitals participating in the 340B drug pricing program and reversed payment cuts in place...more

Supreme Court Holds Benefit Plan Limiting Dialysis Reimbursement Does Not Run Afoul of Medicare Secondary Payer Act

ArentFox Schiff on 7/7/2022

On June 21, 2022, the Supreme Court concluded, in Marietta Memorial Hospital Employee Health Benefit Plan v. DaVita Inc., No. 20-1641, 2022 WL 2203328 (U.S. June 21, 2022), that the terms of a benefit plan limiting...more

Supreme Court Overturns Medicare Outpatient Drug Rate Cut for 340B Hospitals

King & Spalding on 6/28/2022

On June 15, 2022, the Supreme Court issued a unanimous ruling in American Hospital Assn. v. Becerra declaring that CMS’s 2018 and 2019 reimbursement outpatient drug rate cut to 340B hospitals was “contrary to the statute and...more

Supreme Court Decision Maintains Status Quo for Disproportionate Share Percentage Calculation: What Does It Mean for the 340B...

Quarles & Brady LLP on 6/27/2022

Last week, the Supreme Court released a decision relating to how the Department of Health and Human Services (HHS) requires hospitals to calculate its disproportionate share percentage. While this percentage is primarily used...more

Holland & Knight Health Dose: June 22, 2022

Holland & Knight LLP on 6/23/2022

Holland & Knight Health Dose is an in-depth weekly dose of legislative and regulatory insights to keep stakeholders abreast of happenings in Washington, D.C., impacting the health sector. This week's topics include ...more

340B Hospitals Win in Medicare OPPS Supreme Court Decision

Foley & Lardner LLP on 6/21/2022

The Supreme Court issued a long-awaited victory to 340B hospitals this week, when it held in American Hospital Association et al. v. Becerra et al. that the Department of Health and Human Services (HHS) had set unlawful...more

Supreme Court Strikes Down Medicare Part B Reimbursement Reduction for 340B Drugs

Manatt, Phelps & Phillips, LLP on 6/16/2022

The Supreme Court yesterday issued a unanimous opinion striking down the federal government’s reduction in Medicare Part B reimbursement for 340B drugs for calendar years 2018 and 2019. As background, the Centers for Medicare...more

U.S. Supreme Court Sides with 340B Hospitals in Significant $1.6 Billion Part B Drug Payment Ruling

Quarles & Brady LLP on 6/16/2022

On June 15, 2022, after many years of ongoing litigation, the U.S. Supreme Court unanimously overturned a substantial Medicare Part B payment reduction to many 340B Program participating hospitals related to certain...more

The Supreme Court - June 15, 2022

Dorsey & Whitney LLP on 6/16/2022

Viking River Cruises, Inc. v. Moriana, No. 20-1573: This case involves the Federal Arbitration Act’s (FAA) preemption of a California law invalidating contractual waivers of the right to assert certain representative claims....more

340B Medicare Reimbursement Cuts Ruled Unlawful by Supreme Court

Husch Blackwell LLP on 6/16/2022

Today, the U.S. Supreme Court ruled in favor of the American Hospital Association and against the Department of Health and Human Services (HHS), holding that the 2018 and 2019 Medicare reimbursement cuts for 340B hospitals...more

Supreme Court unanimously sides with American Hospital Association, 340B hospitals over outpatient drug reimbursement rates; 340B...

Bricker Graydon LLP on 6/15/2022

On Friday, June 24th, the Supreme Court unanimously agreed with the American Hospital Association (AHA) and 340B hospitals regarding their challenge to outpatient prescription drug reimbursement methodologies issued by the...more

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Supreme Court of the United States › Medicare › Reimbursements

Post-Chevron Health Care Regulations: The Dawn of a New Day

Supreme Court Overturns Chevron in Landmark Decision with Broad Implications for Medicare Reimbursement Litigation

What the Supreme Court's "Chevron Deference" Ruling Could Mean for Health Care Law

Supreme Court’s SuperValu Decision: a Game-Changer for Assessing FCA Violations

Supreme Court FCA Decision and NLRB GC Memo on Non-Competes

Investigations Newsletter: Supreme Court Again Tightens FCA Intent, But Tricky Questions Linger

Supreme Court Clarifies FCA Scienter Standard – Overturns 7th Circuit Decision

High Court Hears Important Case on False Claims Act’s Scienter

The Government’s Ability to Combat Fraud is on the Line in False Claims Act Supreme Court Case

Knowing IS the Battle: Supreme Court to Address the FCA’s Scienter Standard

CMS Reverses 340B Payment Cuts for 2023 but Does Not Address Remedy for Prior Years

Supreme Court Holds Benefit Plan Limiting Dialysis Reimbursement Does Not Run Afoul of Medicare Secondary Payer Act

Supreme Court Overturns Medicare Outpatient Drug Rate Cut for 340B Hospitals

Supreme Court Decision Maintains Status Quo for Disproportionate Share Percentage Calculation: What Does It Mean for the 340B...

Holland & Knight Health Dose: June 22, 2022

340B Hospitals Win in Medicare OPPS Supreme Court Decision

Supreme Court Strikes Down Medicare Part B Reimbursement Reduction for 340B Drugs

U.S. Supreme Court Sides with 340B Hospitals in Significant $1.6 Billion Part B Drug Payment Ruling

The Supreme Court - June 15, 2022

340B Medicare Reimbursement Cuts Ruled Unlawful by Supreme Court

Supreme Court unanimously sides with American Hospital Association, 340B hospitals over outpatient drug reimbursement rates; 340B...

U.S. Supreme Court Hears Oral Arguments in Two Hospital Cases This Week

Reimbursement Issues Worth Noting: Administrative Law and False Claims Act Implications

Three Pressing Challenges for Personalized Medicine

The ERISA Litigation Newsletter - August 2015

Supreme Court of the United States › Medicare › Reimbursements

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