By Zack Buck Yet another case that examines the authority of administrative agencies to interpret health care laws will make its way to the Supreme Court next term. And the case could have major implications for hospital financing as well. In June 2024, the U.S. Supreme Court granted cert in Advocate Christ Medical, et al….
The focus of the nascent Biden administration has been on making private health insurance more durable, not deconstructing it.
By Zack Buck In a 2-1 decision, a three-judge panel of the Fourth Circuit Court of Appeals has struck down Maryland’s pharmaceutical price-gouging law. The law, which went into effect on October 1 of last year, prohibited drug manufacturers from imposing “unconscionable” price increases, empowering the state attorney general to assess civil penalties against drug…
By Nicolas Terry and Frank Pasquale Subscribe to TWIHL here! Our annual Back To School Special returns in time for a new semester. In this second part, we welcome TWIHL All-Stars Erin Fuse Brown, Zack Buck, and Jessica Roberts. In this part, topics included state health laws in the time of Trump, price and cost issues, ERISA, MIPS, a fraud and abuse case…
By Zack Buck A particularly noteworthy health care fraud case—one that could have a major impact on the falsity requirement of the Federal Civil False Claims Act (FCA)—awaits a decision from the Eleventh Circuit as we enter the second half of 2017. U.S. v. AseraCare, a case that could determine whether “objective falsity” and not only…
By Zack Buck With little fanfare, last month, the Centers for Medicare and Medicaid Services (CMS) abandoned its proposal to begin a payment pilot in which Medicare Part B would change the way it pays for pharmaceutical drugs. As I blogged about last March, under the proposed pilot, providers’ payments would be changed from the…
By Nicolas Terry and Frank Pasquale Subscribe to TWIHL here! This week’s podcast features conversation with University of Tennessee Professor Zack Buck. His recent research suggests an interesting fiduciary approach to dealing with the problem of over-treatment and also ponders the best way to deal with the “financial toxicity” that results from related phenomena. Zack’s work is archived at SSRN. He has…
By Zack Buck In the ongoing fight to control the cost of health care, new understanding of the phenomenon of financial toxicity could play a vital role. Seen currently in the long-term cancer context, recent studies (here and here, and discussed here and here) have shown that individuals experiencing financial distress as a result of the cost…
By Zack Buck Following news last week that Aetna was pulling out of health care insurance exchange markets in eleven states, Pinal County, Arizona became the epicenter in the rapidly evolving and growing crisis facing the Affordable Care Act’s insurance exchanges. Sandwiched between Phoenix and Tucson, Pinal County is home to about 400,000 residents, but…
By Zack Buck Following months of news coverage highlighting how American drug prices are “out of control,” the Centers for Medicare and Medicaid Services (CMS) seems to have been spurred into action. Last week, CMS proposed a new reimbursement regime for drugs paid for by Medicare Part B (drugs administered on an outpatient basis). Addressing the concerns that…
