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Medicare Act Appeals

Robinson+Cole Health Law Diagnosis

Supreme Court Decides in Favor of 340B Hospitals Regarding Medicare Reimbursement Methodology

On June 15, 2022, the U.S. Supreme Court unanimously ruled in favor of “340B” hospitals in a notable statutory interpretation case concerning how the federal Medicare program reimburses hospitals for prescription drugs. The...more

Buchalter

Non-contracted Providers Must Exhaust Administrative Remedies for Medicare Advantage Claims

Buchalter on

Health plans routinely assert that contracted providers must appeal underpayments or claim denials according to the health plans’ internal dispute process. The payer/provider agreement itself, or provider manuals that health...more

King & Spalding

Seventh Circuit Upholds Dismissal of Medicare Overpayment Lawsuit Brought by Home Health Agency for Failing to Complete...

King & Spalding on

On June 3, 2021, the Seventh Circuit upheld a decision by the U.S. District Court of the Northern District of Illinois to dismiss a home health agency’s lawsuit against a Medicare integrity contractor for temporarily...more

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