News & Analysis as of

Administrative Procedure Act Reimbursements

Bond Schoeneck & King PLLC

Albany Supreme Court Decision Overturns Health Care Rate Reduction; Requires Rule-Making for Reimbursement Methodology Change

In a case brought by Bond, Schoeneck & King, the Albany County Supreme Court has overturned hundreds of millions of rate cuts implemented at the direction of the New York State Department of Health. The court, fully adopting...more

ArentFox Schiff

Court Halts Trump Administration Order Pausing Government Grants (For Now)

ArentFox Schiff on

Many parties are rightly concerned about the impact of yesterday’s announcement that nearly all federal funds will be frozen for an indeterminate period. Minutes before it was intended to go into effect today, a federal judge...more

King & Spalding

Ninth Circuit Vacates Low-Wage-Index Policy

King & Spalding on

On December 11, 2024, the Ninth Circuit struck down an HHS policy that boosted the wage index, and therefore the Medicare reimbursement rate, for hospitals in low-income communities in Kaweah Delta Health Care District v....more

King & Spalding

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

King & Spalding on

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

ArentFox Schiff

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

ArentFox Schiff on

“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

Mintz - Health Care Viewpoints

PAMA Laboratory Reporting In Flux: ACLA Wins HHS Lawsuit and Congress Introduces PAMA Amendment Legislation

Important developments related to required price reporting to Medicare for clinical laboratories under the Protecting Access to Medicare Act of 2014 (PAMA) have recently occurred. As a result, the clinical laboratory...more

Harris Beach Murtha PLLC

Federal Judge Invalidates QPA Provisions of No Surprises Act Regulations

On February 23, 2022, Judge Jeremy Konodle of the U.S. District Court for the Eastern District of Texas, issued a decision in Texas Medical Association v. United States Department of Health & Human Services that invalidated...more

Sheppard Mullin Richter & Hampton LLP

Executive Order on Promoting Competition in the American Economy: The Biden Administration Considers Drug Pricing Strategies While...

On August 10, 2021, the Centers for Medicare and Medicaid (“CMS”) published a proposed rule (“Proposed Rule”) to rescind the Most Favored Nation Model (“MFN Model”) interim final rule that was published on November 26, 2020...more

Epstein Becker & Green

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

Epstein Becker & Green on

News of two distantly related reimbursement issues with administrative law and False Claims Act (“FCA”) implications is worth noting....more

BakerHostetler

Children’s Hospitals Obtain Temporary Injunction Against CMS

BakerHostetler on

Challenging actions by the Centers for Medicare & Medicaid Services (CMS) under the Administrative Procedures Act (APA), Texas Children’s Hospital and Seattle Children’s Hospital obtained a preliminary injunction that enjoins...more

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