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Hospitals › Arbitrary and Capricious

King & Spalding

Ninth Circuit Vacates Low-Wage-Index Policy

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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

New Kidney Transplant Allocation Policy Survives Eighth Circuit Legal Challenge

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On November 8, 2021, the Eighth Circuit affirmed a district court order that denied an attempt to preliminarily block the Organ Procurement and Transplant Network’s (OPTN) policy changing the manner in which donor kidneys are...more

Baker Donelson

Federal District Court Upholds CMS Hospital Price Transparency Rule, Reporting to Begin January 1, 2021

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On June 23, 2020, a federal district court upheld a Centers for Medicare and Medicaid Services (CMS) regulation that requires hospitals to publicly report information regarding their standard charges, including privately...more

Troutman Pepper Locke

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

Troutman Pepper Locke 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

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

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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

UB Greensfelder LLP

Judge Says Canadian Physicians Are Eligible for H-1B Admission Regardless of the J-1 Two-Year Foreign Residency Requirement

UB Greensfelder LLP on

A federal judge in New York has ruled that Canadian physicians who are subject to the J-1 two-year foreign residency requirement may enter the United States in H-1B status, even though they have not spent two years in Canada...more

Baker Donelson

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

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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

Baker Donelson

The Battle over Medicare's Treatment of Provider Taxes May be Coming to an End

Baker Donelson on

For much of the past decade, hospitals and CMS have battled over whether providers may claim, as Medicare reasonable costs, the full amount of provider tax assessments levied upon them by the states in which they operate. In...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...

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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

Baker Donelson

Challenges to Medicare's Outlier Payment Rules - the Secretary Largely Prevails

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As we reported in an earlier Payment Matters article, the United States Court of Appeals for the District of Columbia Circuit handed hospitals a partial victory on May 19, 2015, in their challenge to Medicare outlier payments...more

Foley & Lardner LLP

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

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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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