Litigation
The Court concluded that the defendants 鈥 the U.S. Department of Health and Human Services and its Secretary (referred to collectively throughout as 鈥渢he Agency鈥) 鈥 acted in an ultra vires fashion by reducing the payment rate for drugs purchased through the 340B Program in the 2018 Outpatient鈥
In November 2018, Defendants issued a regulation requiring that, for calendar year 2019, the Centers for Medicare & Medicaid Services (CMS) reimburse drugs purchased under section 340B of the Public Health Services Act ("340B drugs") by using a methodology based on Average Sales Price minus 22.鈥
The AHA, Association of American Medical Colleges and America鈥檚 Essential Hospitals today said they expect to 鈥渞efile promptly in district court鈥 their lawsuit challenging a nearly 30% Medicare payment reduction for many hospitals in the 340B drug savings program.
Twenty-eight health care organizations, including the AHA, yesterday urged the Centers for Medicare & Medicaid Services to reconsider its decision to suspend $10.4 billion in risk adjustment transfers to insurers for 2017 until certain litigation is resolved.
Amicus Brief: Southern Baptist Hospital of Florida, Inc. Vs Jean Charles Jr. Guardian, Marie Charles Et Al
The 黑料正能量 Association (AHA) is pleased to support your legislation, the Two-Midnight Rule Coordination and Improvement Act of 2014 (S. 2082), to delay enforcement of the Medicare inpatient admission and review criteria (the two-midnight policy).
H.R.3991 would amend the Social Security Act to remove the condition of payment but leave the condition of participation intact. A physician would not be required to state that the patient will be discharged or transferred in less than 96 hours in order for the CAH to be paid on that particular鈥
The AHA, several hospital associations (Greater New York, New York State, New Jersey and Pennsylvania) and four hospital systems today took the first steps to bring a federal court challenge to the Centers for Medicare & Medicaid Services鈥 two-midnight inpatient admissions criteria and related鈥
Delays of at least two years in granting an ALJ hearing for an appealed claim are not only unacceptable, they are a direct violation of Medicare statute that requires ALJs to issue a decision within 90 days of receiving the request for hearing.
This letter is in regards to Good Shepherd Health Care System鈥檚 recent experience with a qui tam fraud investigation under the False Claims Act.