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Department of Health and Human Services (HHS) Arbitrary and Capricious

Rivkin Radler LLP

Pharma Coalition Files Suit Against HHS over OIG Advisory Opinion

Rivkin Radler LLP on

On November 9, the Pharmaceutical Coalition for Patient Access (PCPA) filed an action against the U.S. Department of Health and Human Services (HHS) after HHS’s Office of Inspector General (OIG) determined that a proposed...more

Cozen O'Connor

Florida Sues CDC Over COVID-19-Related Framework For Resumption Of Cruises

Cozen O'Connor on

Florida AG Ashley Moody sued the U.S. Department of Health and Human Services and the U.S. Centers for Disease Control and Prevention (“CDC”) over allegations that the CDC’s Framework for Conditional Sailing and Initial Phase...more

Jackson Lewis P.C.

Court Decision Restores Affordable Care Act’s Discrimination Protections For Transgender Patients

Jackson Lewis P.C. on

A New York court has restored anti-discrimination protections for transgender patients under the Affordable Care Act (ACA). Walker et al. v. Azar et al., No. 20-cv-2834 (E.D.N.Y. Aug. 17, 2020). Section 1557 of the ACA...more

Troutman Pepper

D.C. District Court Upholds Rule Requiring Hospitals To Disclose Privately Negotiated Insurances Prices

Troutman Pepper on

On June 23, the U.S. District Court for the District of Columbia dismissed a challenge to a federal rule requiring hospitals to disclose prices they privately negotiated with insurers....more

King & Spalding

Ninth Circuit Upholds HHS Authority on Abortion Gag Rule

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On February 24, 2020, the Ninth Circuit, sitting en banc, upheld the Trump administration’s regulation that prohibits grantees under Title X of the Public Health Service Act from referring patients for, or otherwise...more

King & Spalding

Federal Appeals Court Strikes Down Arkansas Medicaid Work Requirements

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On February 14, 2020, the United States Court of Appeals for the District of Columbia Circuit issued its decision in Gresham et al. v. Azar et al., Case No. 19-5094, a case challenging HHS’s Medicaid waiver that allowed...more

King & Spalding

Federal Court Partially Grants Motion to Dismiss Clearing Way for New HHS Liver Allocation Policy to Go into Effect

King & Spalding on

On January 21, 2020, the U.S. District Court for the Northern District of Georgia granted in part and denied in part a motion challenging a new HHS policy for allocating livers to transplant patients in the United States. The...more

Mintz - Health Care Viewpoints

Did the Tenth Circuit Just Put the Final Nail in the Coffin for Challenges to the Use of “Statewide Average Premium” in Risk...

On December 31, 2019, the Tenth Circuit Court of Appeals upheld the Department of Health & Human Services’ Affordable Care Act (ACA) risk adjustment methodology in New Mexico Health Connections v. HHS, No. 18-2186 (10th Cir....more

Sheppard Mullin Richter & Hampton LLP

Arkansas and Kentucky Halt Medicaid Work Requirements

On April 10, 2019, the Department of Justice filed notices appealing two District Court rulings that struck down Medicaid work requirements in both Kentucky and Arkansas to the U.S. Court of Appeals for the District of...more

Baker Donelson

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

Baker Donelson on

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

Mintz - Health Care Viewpoints

New Mexico Court Affirms Ruling in ACA Risk Corridor Case

On October 19, 2018, a New Mexico district judge rejected a request from HHS to reconsider a February decision that had briefly led to the suspension of the ACA’s risk adjustment program. In February, District Judge James...more

Mintz - Health Care Viewpoints

CMS, In a Reversal, Announces Plans to Continue Funding Risk Adjustment Payments

On Wednesday, August 8, CMS filed a proposed rule clearing the way for the federal government to continue making payments under the ACA’s risk adjustment program for the benefit year 2018. The 2018 proposed rule is...more

Dechert LLP

DC Circuit shuts down effort to limit TCPA liability for communicating health information

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The U.S. Court of Appeals for the D.C. Circuit, on March 16, 2018, struck a blow to healthcare industry efforts to exclude certain communications subject to the Health Insurance Portability and Accountability Act (HIPAA) from...more

King & Spalding

HHS Wins Summary Judgment Against Hospitals Disputing CMS’s Treatment of Part C Days as Days “Entitled to Part A” for Purposes of...

King & Spalding on

On August 17, 2016 the United States District Court for the District of Columbia granted summary judgment in favor of HHS in a dispute over whether Part C days can be treated as “days entitled to benefits under Part A” for...more

Foley & Lardner LLP

Court Strikes Down 340B Orphan Drug Rule Again: Will This Impact the “Mega Guidance”?

Foley & Lardner LLP on

A federal court vacated the Department of Health and Human Services’ (HHS) Orphan Drug Rule that had allowed certain 340B Drug Pricing Program (340B Program) hospital covered entities to receive discounted prices when...more

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