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High Court Rules for Government on Drug Reimbursement – ​​Chicago Tribune

The Supreme Court said Wednesday that the federal government improperly reduced drug reimbursement payments to hospitals and clinics servicing low-income areas, spending billions of dollars on facilities.

The High Court unanimously ruled Used by Medicare patients in the outpatient department of the hospital, primarily with the payment of cancer medications. The Biden administration supported the Trump administration’s decision to reduce payments.

The government said hospitals and clinics have a special position in servicing low-income communities, so they can buy medicines at significant discounts.The The government said Reimbursement to a hospital called 340B Hospital at the same rate as other hospitals that pay more has created an incentive for hospitals to overprescribe or prescribe more expensive medicines. He said lowering the repayment amount is related to the repayment rate, so it also saves the copayment of Medicare beneficiaries.

Judge Brett Kavanaugh wrote in court that “without an investigation into the cost of buying a hospital,” the Department of Health and Human Services “may not change the reimbursement rate for 340B Hospital.” Therefore, HHS’s 2018 and 2019 340B hospital reimbursement rates were in violation of the law and were illegal. “

In a statement, the Chicago-based American Hospital Association and other groups involved in the case described the decision as “a decisive victory for vulnerable communities and hospitals that rely on so many patients.” called. They want to work with governments and courts on redemption plans.

The judge’s previous case involved Medicare, which provides health insurance to approximately 60 million people over the age of 65 or people with certain disabilities. Under Medicare, healthcare providers will be reimbursed by the government for costs, including medicines used in the outpatient department of the hospital.

The hospital was reimbursed at a rate based on the average price of the drug. However, in 2018, the Trump administration said 340B hospitals and clinics servicing low-income communities will be reimbursed at a lower rate. This is because 340B hospitals and clinics are entitled to discounts from pharmaceutical companies that allow them to buy medicines at a lower cost. The government has reduced the reimbursement rate by about 30%, reducing it to about $ 1.6 billion annually to 340 billion hospitals and clinics.

The affected hospitals filed proceedings, and federal judges first ruled them, but the decision was revoked by the Court of Appeals.

The case is American Hospital Association vs. Besera, 20-1114.

High Court Rules for Government on Drug Reimbursement – ​​Chicago Tribune

Source link High Court Rules for Government on Drug Reimbursement – ​​Chicago Tribune

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