Compliance & Legal
An ongoing legal battle has made the price transparency final rule contentious, but its implementation may be inevitable.
Sutter Health cited "catastrophic" losses related to the coronavirus pandemic.
The rule would create a separate hospital payment category for CAR-T therapy, providing predictable payment rates for hospitals.
The defendants allegedly used their management companies to take over rural hospitals in financial trouble and then used them to bill for testing.
The reduction is linked to a federal court ruling that established annual deadline-based targets.
The administration claims the law is unconstitutional without the individual mandate.
A federal judge today sided with the Department of Health and Human Services and rejected providers' claims.
The resolution was spurred by a 73-year-old with aphasia who was denied access to support persons, prompting state action.
The insurers claim that CVS submitted claims for payment at artificially inflated prices and concealed the true cash price of the drugs.
Insurers will be issuing a total of about $2.7 billion in refunds, estimates the Kaiser Family Foundation.