Hospitals sue HHS over lengthy RAC appeals

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The hospitals are demanding the agency fulfill its requirement to decide Medicare payment appeals within 90 days, instead of the current 16-month average. Meanwhile, the pharmaceutical industry scored a victory Friday in its efforts to limit hospitals' access to lower-priced drugs through the 340B drug discount program.

Modern Healthcare:  Hospitals Sue HHS Over Sluggish RAC Appeals
Administrators at Baxter Regional Hospital in Mountain Home, Ark., say they have so much money tied up in endless Medicare appeals that they can't afford to replace the roof over their surgery department or buy new beds for their intensive-care unit. Baxter joined two other hospital-care providers and the American Hospital Association on Thursday in a federal lawsuit against HHS asking a judge to force the agency to meet its statutory requirement to decide Medicare-payment appeals within 90 days instead of the current average of 16 months (Carlson, 5/23).

Modern Healthcare:  Court Deals Setback To Hospital 340B Discounts
The pharmaceutical industry scored another victory Friday in its battle to limit access to lower-priced drugs through HHS' 340B drug discount program. A U.S. district court judge ruled rural and cancer hospitals participating in 340B program could not buy high-priced orphan drugs at discounted prices if the drugs were being used off-label, according to Drug Discount Monitor, the newsletter of the Safety Net Hospitals for Pharmaceutical Access (5/24).


http://www.kaiserhealthnews.orgThis article was reprinted from kaiserhealthnews.org with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health care policy research organization unaffiliated with Kaiser Permanente.

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