News & Analysis as of

Department of Health and Human Services (HHS) Medical Reimbursement

Troutman Pepper

D.C. Circuit Dismisses Appeal of Class Certification Denial Due to Lack of Standing

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The U.S. Court of Appeals for the District of Columbia Circuit recently dismissed an appeal in the case of Lewis v. Becerra, Secretary of the United States Department of Health and Human Services (HHS). The appellants sought...more

Wilson Sonsini Goodrich & Rosati

Medicare Contractors Buy Additional Time for the Digital Health Industry

The explosive growth in telehealth over the past five years has resulted from, among other things, the Centers for Medicare & Medicaid Services’ (CMS) extension of Medicare reimbursement to remote monitoring of patients by...more

Rumberger | Kirk

The Multiple Issues Surrounding Medicare and Past Damages

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What amount of past medical expenses can a plaintiff present to the jury when he or she is a Medicare recipient? The short answer: only the amount of past medical expenses the plaintiff is obligated to pay, not the gross...more

Baker Donelson

COVID-19 PANDEMIC: Extension of PHE and Impact to FEMA Claims

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On October 13, 2022, the Secretary of the U.S. Department of Health and Human Services (HHS), Xavier Becerra, once again renewed the declaration of a Public Health Emergency (PHE) under the Public Health Service Act due to...more

Holland & Knight LLP

Back to the Future for Telehealth: Refocusing on Security and Quality

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Telehealth has been around for decades, but restrictive reimbursement rules kept it out of widespread use for many treatment needs. Then along came the COVID-19 pandemic and everything changed rapidly. Suddenly, due to the...more

Burr & Forman

The DOJ Continues to Scrutinize Telemedicine

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Telemedicine saw a dramatic increase during the COVID-19 pandemic. A recent study from the U.S. Department of Health and Human Services (HHS), released in December 2021, showed an increase in Medicare telemedicine visits...more

Schwabe, Williamson & Wyatt PC

Employer Provided Travel Benefits in Response to Dobbs and State Prohibitions on Abortion

The implications of the United States Supreme Court’s decision in Dobbs v. Jackson Women’s Health Organization that overturned Roe v. Wade’s constitutional right to abortion have had sweeping implications that affect...more

Robinson+Cole Health Law Diagnosis

Supreme Court Decides in Favor of 340B Hospitals Regarding Medicare Reimbursement Methodology

On June 15, 2022, the U.S. Supreme Court unanimously ruled in favor of “340B” hospitals in a notable statutory interpretation case concerning how the federal Medicare program reimburses hospitals for prescription drugs. The...more

Baker Donelson

Convening and Co-Provider Responsibilities under the No Surprises Act

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The No Surprises Act (NSA), which took effect on January 1, 2022, includes protections from surprise bills for patients who are uninsured or covered under group or individual plans. It will be necessary for both facilities...more

Baker Donelson

HHS Agency Financial Report Provides Insight Into "Improper" Payments

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The Department of Health and Human Services (HHS) recently issued its 2021 Agency Financial Report (AFR), summarizing HHS' fiscal and high-level program results to allow assessment of the agency's performance over the prior...more

ArentFox Schiff

Supreme Court To Hear Case Impacting Medicare Reimbursement for 340B Drugs

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The United States Supreme Court has agreed to hear a case that has a direct impact on the 340B Drug Discount Program (the 340B Program) and how Medicare will reimburse hospitals for dispensing of 340B covered drugs, as well...more

Hogan Lovells

COVID-19 Report for Life Sciences and Health Care Companies (UPDATED)

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The COVID-19 Report is a compilation of coronavirus news, analysis, and insights from around the world to help life sciences and health care companies stay current in this challenging time. In Tuesday's Report: FDA revokes...more

Robinson+Cole Health Law Diagnosis

CMS Announces New Telehealth Services Covered by Medicare and Provides States with Medicaid and CHIP Telehealth Expansion...

On October 14, 2020, the Centers for Medicare & Medicaid Services (CMS) expanded the list of telehealth services covered by Medicare during the COVID-19 Public Health Emergency. CMS also announced it would be providing...more

Katten Muchin Rosenman LLP

Health Care Law Perspectives - November 2019 • Volume I

CMS’ 340B Rate Cut Continues to Dampen Hospital Outpatient Expansion Efforts - Hospitals hoping to benefit from favorable 340B drug pricing when acquiring independent physician practices for conversion to hospital...more

Bricker Graydon LLP

Could relief from the Medicare cuts in reimbursement for 340B drugs be coming soon for hospitals? (UPDATE)

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Update: Following the court’s decision in May 2019, both the plaintiff hospitals and HHS filed further motions in the case – the plaintiffs moved for a firm date by which HHS must propose a remedy to the court. HHS moved for...more

Manatt, Phelps & Phillips, LLP

Court Again Rejects Medicare Part B Cuts for 340B Drugs

On May 5, a federal district court judge ruled in favor of the hospital industry plaintiffs that sued the Department of Health and Human Services (HHS) for including in the 2019 Hospital Outpatient Prospective Payment System...more

K&L Gates LLP

K&L Gates Triage: Triage in 2019: Health Care Topics to Watch in the New Year

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As K&L Gates begins its third season of Triage: Rapid Legal Lessons for Busy Health Care Professionals, Hilary Bowman previews several topics that the health care practice group anticipates will have a significant impact on...more

Sheppard Mullin Richter & Hampton LLP

340B Drug Pricing Program Litigation Update: Court Rejects CMS Drug Pricing Cuts

On December 27, 2018, the U.S. District Court for the District of Columbia issued an opinion that ruled against the Trump Administration in its plan to cut funding from the 340B Drug Pricing Program (“340B Program”). ...more

Bricker Graydon LLP

Federal court overturns 340B Drug Discount Program reimbursement cuts – future still uncertain

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On December 27, 2018, the District Court for the District of Columbia issued a decision in American Hospital Association, et al. v. Azar, No.18-2084(RC) (D.D.C. December 27, 2018), holding that the cuts imposed by the...more

Polsinelli

Federal Judge Overturns Part B Payment Cuts to the 340B Drug Discount Program

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A federal district court granted a permanent injunction against the Medicare Part B 2018 Outpatient Prospective Payment System (“OPPS”) payment cuts for separately payable, non-pass through drugs purchased through the 340B...more

Holland & Knight LLP

Healthcare Law Update: September 2018

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Regulation - CMS Contemplating Telemedicine Changes - The Centers for Medicare & Medicaid Services (CMS) recently published what it described as a "major proposed rule" that covers a number of topics that could have...more

Foley & Lardner LLP

340B: DC Circuit Affirms Dismissal of Challenge to 2018 Reimbursement Cuts for 340B Hospitals; New Cuts Already Being Proposed by...

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On Tuesday, July 17, 2018, the United States Court of Appeals for the District of Columbia ended a challenge brought by hospitals and hospital associations to the nearly 28 percent reimbursement cuts for 340B hospitals under...more

Bricker Graydon LLP

Federal appeals court rules against the American Hospital Association’s challenge to the $1.6 billion in Medicare 340B cuts

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On July 17, 2017, the U.S. Court of Appeals for the District of Columbia Circuit ruled in favor of the Department of Health and Human Services (HHS), finding that the American Hospital Association’s (AHA) legal challenge of...more

Foley & Lardner LLP

Top 5 Ways Telehealth Will Change Under the New Federal Funding Bill

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The telemedicine industry has been abuzz upon learning that provider-friendly legislation was included in the new federal Bipartisan Budget Act of 2018, signed into law by the President on February 9, 2018. But telehealth...more

Hogan Lovells

2019 White House and HHS Budgets Released: Key Changes to Drug Pricing and Reimbursement Proposed

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On February 12, 2018, the White House Office of Management and Budget released an overview of the president's Fiscal Year (FY) 2019 Budget (the Budget), which makes, among many others, several proposals regarding drug pricing...more

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