The US District Court for the District of Columbia recently held that the Centers for Medicare and Medicaid Services (CMS) exceeded its authority by reducing Medicare payment rates for 340B drugs, but, because of the budget-neutral nature of the cuts, the court left implementation details of its order temporarily unresolved to avoid disrupting administration of the Medicare Hospital Outpatient Prospective Payment System. It remains to be seen what remedies the court will ultimately order and whether CMS will appeal the decision.
Emily J. Cook provides counsel to health care providers on complex regulatory and reimbursement matters. Her regulatory experience includes fee-for-service Medicare and Medicaid reimbursement, billing and coding, licensure, survey/certification and accreditation, and compliance with Medicare and state fraud and abuse requirements. She also has significant experience counseling health care providers and other stakeholder entities on issues related to 340B drug pricing program implementation, compliance and advocacy. Read Emily Cook's full bio.