News & Analysis as of

Ninth Circuit Vacates Injunctions Barring HHS From Seeking Prepayment of Medicare Secondary Payer Reimbursements

The United States Court of Appeals for the Ninth Circuit recently vacated injunctions entered by a district court that banned HHS from seeking “up front” reimbursements for Medicare secondary payments from beneficiaries who...more

Monthly Benefits Update - April 2013

Health Care Reform: Guidance on Required Future Modifications to SBC, Other Issues - The Internal Revenue Service (IRS), Department of Labor (DOL), and Department of Health and Human Services (HHS) issued new guidance...more

6th Circuit Rules in Favor of HHS on Dual-Eligible Exhausted Benefit Days Issue

On March 27, 2013, the 6th Circuit, sitting en banc, issued its decision in Metropolitan Hospital v. U.S. Department of Health and Human Services, Case Nos. 11-2465\2466. At issue in the case was whether the HHS Secretary’s...more

OIG Concludes in Nationwide Review of Drug That Herceptin Has Often Been Overbilled

The HHS OIG has conducted a nationwide audit of the use and reimbursement of Herceptin (also known as trastuzumab), a Medicare-covered drug used to treat metastatic breast cancer, and has concluded in three audits released in...more

Departments Release 11th Set of FAQs under the Affordable Care Act

On January 24, the Departments of Labor, Health and Human Services, and the Treasury (the Departments) released the eleventh in a series of frequently asked questions and answers (FAQs) regarding the implementation of the...more

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