Jeffrey Davis

Jeffrey Davis

Baker Donelson

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Federal Appeals Court Upholds Payment Reduction to 340B Hospitals

On July 31, 2020, the D.C. Circuit Court of Appeals issued a decision reversing a lower court decision and upholding Medicare payment cuts to certain hospitals participating in the 340B drug pricing program that have been in...more

8/20/2020  /  Administrative Authority , Appeals , Centers for Medicare & Medicaid Services (CMS) , Department of Health and Human Services (HHS) , Drug Pricing , Hospitals , Medicare Part B , Medicare Payment Reform , Outpatient Prospective Payment System (OPPS) , Payment Rates , Reversal , Section 340B

A Flurry of Recent Activity Highlights Continued Interest in 340B Program Oversight

Four separate government releases coming over a three-week period have once again highlighted the intense interest in the 340B drug pricing program, with a federal agency and two government watchdog groups issuing guidance...more

1/30/2020  /  Audits , Centers for Medicare & Medicaid Services (CMS) , Discounts , Drug Pricing , GAO , Health Care Providers , Hospitals , HRSA , Information Reports , Medicaid , Medicare , Medicare Part B , MedPAC , New Guidance , Non-Profit Hospitals , Pay Reductions , Prescription Drugs , Provider Payments , Regulatory Agenda , Regulatory Oversight , Section 340B , State and Local Government

Oral Arguments Scheduled in Challenge to 340B Payment Cuts While HHS Solicits Comments on Potential Remedy for 340B Hospitals

The D.C. Circuit Court of Appeals has scheduled oral arguments for November 8, 2019 in the ongoing lawsuit challenging Medicare payment cuts to hospitals in the 340B drug pricing program. The court is considering an appeal by...more

9/30/2019  /  Appeals , Department of Health and Human Services (HHS) , Medicare , Medicare Part B , Oral Argument , Outpatient Prospective Payment System (OPPS) , Pharmaceutical Industry , Prescription Drugs , Public Comment , Section 340B

Government Appeals Decision Declaring 340B Payment Cuts Unlawful; District Court Continues to Consider Question of Relief

The U.S. government has appealed a federal district court decision issued in December 2018 that found the Department of Health & Human Services (HHS) exceeded its authority by reducing Part B drug reimbursement to certain...more

3/19/2019  /  Abeyance , Appeals , Arbitrary and Capricious , Centers for Medicare & Medicaid Services (CMS) , Department of Health and Human Services (HHS) , Drug Pricing , Hospitals , Lack of Authority , Medicare , Medicare Part B , Outpatient Prospective Payment System (OPPS) , Prescription Drug Coverage , Prescription Drugs , Remedies , Section 340B

Administration Drug Pricing Proposals Could Reduce Provider Payments

As the Trump Administration moves forward with proposed policy changes to address high drug prices, a common theme is emerging: a number of the proposals have the potential to reduce Medicare reimbursement to hospitals and...more

8/10/2018  /  Add-ons , Centers for Medicare & Medicaid Services (CMS) , Comment Period , Department of Health and Human Services (HHS) , Drug Pricing , Federal Health Care Programs (FHCP) , Health Care Providers , Hospitals , MCOs , Medicaid , Medicare , Medicare Advantage , Medicare Part B , Medicare Part D , MedPAC , Outpatient Prospective Payment System (OPPS) , Pay Reductions , Physician Fee Schedule , Physicians , Prescription Drug Coverage , Prescription Drugs , Provider Payments , Request For Information , Section 340B , Trump Administration

Medicare Issues Proposed Hospital Outpatient Payment Rule, Proposes to Extend Site-Neutral Payment Reductions and 340B Payment...

On July 31, the Centers for Medicare and Medicaid Services (CMS) published a proposed rule outlining the proposed payment rates for 2019 under the Medicare Outpatient Prospective Payment System (OPPS), one of several payment...more

8/8/2018  /  Centers for Medicare & Medicaid Services (CMS) , Drug Pricing , Hospitals , Medicare , Medicare Part B , Off-Campus Departments , Outpatient Prospective Payment System (OPPS) , Physician Fee Schedule , Section 340B

CMS Proposes More Payment Changes for 340B Hospitals in 2019

The Medicare program is once again looking to reduce payments to 340B hospitals for Part B drugs and biologicals. As part of its proposed payment regulation for hospitals under the Outpatient Prospective Payment System (OPPS)...more

8/7/2018  /  Biologics , Biosimilars , Centers for Medicare & Medicaid Services (CMS) , Dismissals , Disproportionate Share Adjustments , Hospitals , Injunctive Relief , Medicare , Medicare Part B , Off-Campus Departments , Outpatient Prospective Payment System (OPPS) , Pay Reductions , Prescription Drug Coverage , Provider Payments , Ripeness , Rural Health Care Providers , Section 340B , Trump Administration

CMS Issues Updated Medicare Payment and Billing Policies for 340B Hospitals

On April 2, 2018, CMS issued updated guidance related to the dramatic Medicare payment reductions that went into effect this year for certain 340B hospitals. The guidance explains the planned application of the payment cuts...more

4/12/2018  /  Appeals , Bipartisan Agreement , Centers for Medicare & Medicaid Services (CMS) , Department of Health and Human Services (HHS) , Dismissals , Disproportionate Share Adjustments , Exemptions , Hospitals , Medicare , Medicare Advantage , Medicare Part B , New Guidance , Out of Network Provider , Outpatient Prospective Payment System (OPPS) , Pay Reductions , Preliminary Injunctions , Prescription Drugs , Proposed Legislation , Reversal , Ripeness , Rural Health Care Providers , Section 340B , Statutory Authority
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