U.S. Supreme Court Hears Case on Medicaid Reimbursement

| Jan-22-15

Supreme Court

On Tuesday, NACDS Senior Vice President of Legal Affairs & General Counsel Don Bell attended a hearing at the U.S. Supreme Court on the right of pharmacies and other providers to file lawsuits challenging Medicaid reimbursement rates.

The case is significant because it will decide whether pharmacies and other providers can challenge Medicaid reimbursement rates under the same theory that was used in NACDS’ California Medicaid reimbursement case. Bell said in California NACDS prevented hundreds of millions of dollars in pharmacy reimbursement cuts. NACDS and other stakeholders filed a brief with the Supreme Court in December 2014 supporting the right of providers to challenge inadequate reimbursement rates.

Bell said the justices appeared divided in the case, but advised against trying to predict what the justices would ultimately conclude. A decision is anticipated by June of this year. Bell said, “If they do rule against pharmacies and other providers, it wouldn’t entirely eliminate the ability of pharmacies to challenge Medicaid reimbursement rates. There are other ways to challenge them.”

NACDS will continue to keep members apprised of any developments in the case.  

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