42 U.S.C. § 13951
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Notes of Decisions
Cited in 66
cases (1 in the last 5 years), 1974–2023 · leading case: Amgen, Inc. v. Scully, 234 F. Supp. 2d 9 (D.D.C. 2002).
Amgen, Inc. v. Scully, 234 F. Supp. 2d 9 (D.D.C. 2002). “Plaintiff alleges that the agency’s action was in direct conflict with the “pass-through” statute, 42 U.S.C. § 13951 (t)(6)(C), which permits reductions in “pass-through” payments only where necessary to maintain total “pass-through” expenditures within a cap.”
In Re Pharm. Indus. Average Wholesale Price Litig., 460 F. Supp. 2d 277 (D. Mass. 2006). “See 42 U.S.C. §§ 13951 (a), 1395u(b); 42 C.F.”
United States Ex Rel. Groat v. Boston Heart Diagnostics Corp., 255 F. Supp. 3d 13 (D.D.C. 2017). “” (citing 42 U.S.C. § 13951 (e); 42 C.F.R. § 424.5 (a)(6)).”
United States Ex Rel. Thompson v. Columbia/HCA Healthcare Corp., 20 F. Supp. 2d 1017 (S.D. Tex. 1998). “42 U.S.C. § 13951 (i)(2)(A)(i). Therefore Medicare does not need, nor does it require, annual cost reports from an ASC before paying claims for services.”
In re Pharm. Indus. Average Wholesale Price Litig., 230 F.R.D. 61 (D. Mass. 2005). “42 U.S.C. § 13951 (a)(l)(S). Many beneficiaries have purchased private “MediGap” (or “wrap around”) insurance, which pays all or some of this 20% co-payment.”
Commonwealth v. Tap Pharm. Prods., Inc., 36 A.3d 1197 (Pa. Commw. Ct. 2011). “2d at 33 , citing 42 U.S.C. § 13951 Further, even accepting BMS’ intended target audience argument, see Arizona Cartridge (where alleged deceptive business practice is targeted to sophisticated purchaser, question of whether it is misleading will be viewed from vantage point of…”
In Re Pharm. Indus. Average Wholesale Price Litig., 263 F. Supp. 2d 172 (D. Mass. 2003). “42 U.S.C. § 13951 (o); (Comply 149.) The drug reimbursement rates are based on “the lower of the actual charge on the Medicare claim for benefits or 95 percent of the national average wholesale price of the drug or biological.”
Texas Clinical Labs, Inc. v. Kathleen Sebel, 612 F.3d 771 (5th Cir. 2010). “The TCLs seek to impermissibly broaden the statute by including provisions that (1) require interest on any written determination of an underpayment; (2) require interest to be paid even if the underpayment determination itself is modified; and (3) require interest to begin…”
Lawrence + Mem'l Hosp. v. Burwell, 812 F.3d 257 (2d Cir. 2016). “Section 401 contains other sub-parts codified in different areas of the Medicare statute, namely 42 U.S.C. § 13951 (t)(16)(A) and 42 U.S.C.”
Cmty. Health Ctr., Inc. v. Wilson-Coker, 175 F. Supp. 2d 332 (D. Conn. 2001). “for such services in an amount (calculated on a per visit basis) that is equal to 100 percent of the average of the costs of the center or clinic of furnishing such services during fiscal years 1999 and 2000 which are reasonable and related to the cost of furnishing such…”
Pharm. Rsch. & Mfrs. of Am. v. United States Dep't of Health & Human Servs., 138 F. Supp. 3d 31 (D.C. Cir. 2015). “The statute limits the payments for “[c]urrent orphan drugs,” however, to “[a] drug or biological that is used for a rare disease or condition with respect to which the drug or biological has been designated as an orphan drug under section 360bb of Title 21____” 42 U.S.C. §…”
Council For Urological Interes v. Sylvia Mathews Burwell, 790 F.3d 212 (D.C. Cir. 2015). “32, Medicare also pays the hospital a fee that covers charges for space, equipment, supplies, diagnostic testing, and the services of any non-physician personnel, 42 U.S.C. § 13951 (t); 42 C.F.R. pt. 419.”
— 42 U.S.C. § 13951(e) — 1 case
Maximum Comfort, Inc. v. Thompson, 323 F. Supp. 2d 1060 (E.D. Cal. 2004).
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