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Supreme Court of the United States › Reimbursements

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... more +
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 -
ArentFox Schiff

No More Surprise Medical Bills: Fifth Circuit Affirms Vacatur of Arbitration Provisions of Surprise Billing Rules (TMA II)

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On August 2, health care providers scored yet another significant victory when the US Court of Appeals for the Fifth Circuit affirmed the vacatur of various federal regulations regarding the arbitration procedures used to...more

ArentFox Schiff

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

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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

King & Spalding

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

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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

Baker Donelson

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

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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

DRI

What Is the Future of Monetary Relief under ERISA, Section 502(a)(3)?

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The Employee Retirement Income Security Act of 1974 (“ERISA”), as amended, regulates virtually every private employee benefit program in the United States. Among other things, ERISA contains its own civil enforcement section,...more

Ackerman & Ackerman, P.C.

How to Make “Just Compensation” More “Just” for Displaced Homeowners

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Last summer, I wrote a blog about why just compensation—which is based on the ‘objective’ standard of what a property would sell for on the open market—shortchanges residential property owners subjected to eminent domain. In...more

ArentFox Schiff

Investigations Newsletter: SCOTUS Declines to Hear False Claims Act Challenge

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SCOTUS Declines to Hear False Claims Act Challenge - On January 22, the US Supreme Court denied a petition to hear a challenge to a Fifth Circuit Court of Appeals decision that upheld scienter and False Claims Act (FCA)...more

Hinshaw & Culbertson - Insights for Insurers

[White Paper] United States Insurance Trends and Decisions 2023

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As 2024 rapidly approaches, we look back at some of the key decisions, trends, and developments impacting the U.S. insurance industry in 2023 and look ahead at some trends and cases to watch in 2024. Insurers continue to...more

King & Spalding

Medicare Advantage Payors Have Not Redressed 340B Underpayments

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CMS recently published its remedy in response to the Supreme Court’s decision that CMS’s 340B outpatient drug payment policy violated the Medicare statute. Many hospitals that are 340B covered entities will now receive tens...more

King & Spalding

CMS Announces Proposed $9 Billion Remedy for Hospitals Underpaid by Unlawful Rate Cut for 340B Drugs

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On July 7, 2023, CMS published its highly-anticipated proposed rule identifying its remedy to reimburse hospitals unpaid by its unlawful 340B drug payment policy (the Proposed Rule). While the Supreme Court found CMS’s 340B...more

Ballard Spahr LLP

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

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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

Schwabe, Williamson & Wyatt PC

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

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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

ArentFox Schiff

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

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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

Davis Wright Tremaine LLP

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

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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

WilmerHale

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

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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

Kohn, Kohn & Colapinto LLP

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

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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

King & Spalding

Supreme Court Ruling in AHA v. Becerra May Affect 340B Hospitals' Reimbursement Rights Against Medicare Advantage Plans

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Hospitals that participate in the 340B program may be entitled to additional monies from Medicare Advantage plans in the wake of the Supreme Court’s decision in AHA v. Becerra. In AHA v. Becerra, a unanimous Supreme Court...more

McCarter & English Blog: Government Contracts...

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

McCarter & English Blog: Government Contracts... on

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

King & Spalding

Court Rules on Retrospective Relief for 340B Hospitals Without Vacating CMS’s Rules

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On January 10, 2023, Judge Contreras of the United States District Court for the District of Columbia ruled that CMS’s 340B drug reimbursement rates dating back to January 1, 2018, were unlawful and underpaid affected...more

K&L Gates LLP

Recent Developments to the 340B Drug Pricing Program

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In this episode Victoria Hamscho, Andrew Ruskin, and Leah Richardson provide an update on key developments to the 340B Program. They discuss the effects of the Supreme Court’s decision earlier this year overturning 340B...more

Bass, Berry & Sims PLC

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

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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

ArentFox Schiff

Gorsuch Says "Chevron Doctrine" is Dead Even Though the US Supreme Court Refuses to Say So

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“Administrative deference” is a key component to the modern regulatory state. The “Chevron doctrine,” i.e., the concept that the courts should defer to relevant agencies’ interpretations of ambiguous statutes they are tasked...more

McDermott Will & Emery

District Court Vacates 340B Cuts, But Don’t Expect Immediate Payment Rate Restoration

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On September 28, 2022, the US District Court for the District of Columbia vacated the 2022 rule under which the US Department of Health and Human Services (HHS) reduced Medicare Part B payments on 340B drugs paid under the...more

Greenbaum, Rowe, Smith & Davis LLP

U.S. District Court Judge Vacates Unlawful Drug Reimbursement Rate For 340B Hospitals for Remainder of 2022

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As we reported previously in this post on our Healthcare Perspectives blog, the U.S. Supreme Court earlier this summer held that the federal government improperly lowered drug reimbursement payments to certain 340B hospitals...more

Bradley Arant Boult Cummings LLP

Dobbs, Workers' Comp. Brief Hint At Biden's Cannabis Stance

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The overturning of Roe v. Wade, combined with a largely unknown workers' compensation case presented to the U.S. Supreme Court — for which certiorari was recently denied — reveal the Biden administration's position on...more

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