The Centers for Medicare & Medicaid Services (CMS) recently published detailed databases summarizing changes of ownership of Medicare-enrolled hospitals and skilled nursing facilities (SNFs). The databases currently include information from 2016 to 2022, but the data will be updated and released quarterly. CMS also released the skilled nursing facility prospective payment system (SNF PPS) proposed rule (the Proposed Rule), including proposed updates to payment based on quality and value-based care measures.
A recent US Department of Health and Human Services (HHS) US Supreme Court loss involving drug reimbursements to hospitals may impact a larger battle over drug discounts for low-income Americans. According to this Blomberg Law article, the Court ruled in June that HHS improperly cut $1 billion a year in drug reimbursements to hospitals through a government program that assists at-need populations. Now, both HHS and hospitals may be on the same side of a different skirmish—whether the agency can require pharmaceutical companies to offer discounts to specific pharmacies. McDermott Partner Emily Jane Cook said language in the Court’s opinion “suggests that the court does have a very favorable view of the 340B program and the hospitals that participate in that program.”
The US Supreme Court’s decision to overturn Roe v. Wade will generate a minefield of legal and criminal implications for healthcare providers, according to this Healthcare Dive article. McDermott Partners Stacey Callaghan and David Gacioch offer insight into what these restrictive state laws could mean for providers.
The US Supreme Court’s decision to overturn Roe v. Wade has left employers—and employees—with more questions than answers. While many employers have promised to pay for their employees to travel across state lines for an abortion, it’s unclear if employers might be sued for doing so. In this USA TODAY article, McDermott’s Sarah Raaii said employers may point to Justice Brett Kavanaugh’s opinion on the “constitutional right to interstate travel” for support.
The patchwork of US federal and state rules governing abortion insurance coverage will become more complicated following the US Supreme Court’s decision to overturn Roe v. Wade. In this MarketWatch article, McDermott’s Sarah Raaii said the situation has employers on edge.
“We’ve had a huge influx of employers reaching out and asking, ‘What should I be doing? Are there risks?’” Raaii said.
In the aftermath of the US Supreme Court’s decision to overturn Roe v. Wade, legal experts say health systems and providers must immediately review their operations and prepare for potential enforcement by state prosecutors. According to this article published in Fierce Healthcare, McDermott Partner Stacey Callaghan said organizations should consult with counsel “as soon as possible” to ensure they understand the new post-Roe landscape.
As the world emerges from the COVID-19 pandemic, healthcare fraud enforcement remains a top priority for the US Department of Justice (DOJ) and other government agencies with enforcement authority. In this Westlaw Today article, McDermott Partners Laura McLane, Tony Maida and Dana M. McSherry describe some of the areas that have assumed particularly high enforcement priority, including private equity, telehealth and pandemic relief funds.
The monumental decision by the Supreme Court of the United States in Dobbs v. Jackson Women’s Health Organization to overturn Roe v. Wade presents significant challenges for employers and health plans. According to this Law360 article, employers should begin reviewing state laws, evaluating internal company policies, gauging employee reactions and preparing for legal challenges. McDermott’s Sarah Raaii called the Supreme Court’s decision “an administrative and potentially employee relations nightmare for employers.”
“It creates a lot of challenges for employers who just want to do right by their employees and continue offering these abortion benefits that they have historically done in the past,” Raaii said.
On June 24, 2022, the Supreme Court of the United States issued its decision in Dobbs v. Jackson Women’s Health Organization (Dobbs), overturning Roe v. Wade (Roe) and upending 50 years of precedent protecting a woman’s right to privacy in choosing to abort a pregnancy prior to the point of viability.
The effect of this decision on US companies cannot be understated. Any organization whose operations touch family planning services in any way (e.g., providers, those that facilitate operations, investors, payors, employers that provide family planning benefits and health plan service providers) should immediately examine their precise services, geographic footprint, corporate structure and organizational priorities.
The 340B program landscape is constantly shifting. Wednesday’s US Supreme Court American Hospital Association v. Becerra decision is of critical importance to hospitals that participate in the 340B program. The Court held that the US Department of Health and Human Services (HHS) improperly imposed a payment cut of almost 30% on 340B drugs paid by Medicare. Yet, while this decision is significant, it is not the end of the litigation surrounding the payment cut. The case has been remanded for further deliberation, which will include a determination of the remedies.
McDermott+Consulting has launched the 340B Litigation Tracking Tool, an up-to-date resource following the 30+ state and federal 340B program legal challenges. No more searching online or sorting through your newsfeed for updates on important case developments. This tracker, available 24/7 and routinely monitored by our team, delivers concise updates to help you make informed risk analyses on what’s next for your business in the evolving 340B landscape.
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