HEALTH & LIFE SCIENCES NEWS

CMS CY 2026 proposed rules: 340B in PFS and OPPS

by Emily Jane Cook | Jul 23, 2025 | 340B

On July 15, 2025, the Centers for Medicare & Medicaid Services (CMS) released the CY 2026 Outpatient Prospective Payment System (OPPS) proposed rule. The proposed rule includes a provision that would increase the reduction in OPPS payment rates to offset the lump sum payments previously paid to 340B hospitals from 0.5% to 2% and would accelerate the period of the reductions from 16 years to six years. This payment reduction would apply to most items and services and most hospitals paid under OPPS. The reduction is not limited to 340B hospitals. CMS also proposes to reduce payments under OPPS for drug administration at most off-campus hospital outpatient departments not already subject to site-neutral payments to the rate paid under the Medicare Physician Fee Schedule (PFS), representing an approximately 65% reduction in payments.

CMS is accepting comments on this proposal through September 13, 2025.

The proposed rule was published in the Federal Register on July 17, 2025 and is available here. Refer to pp. 33631-35 for information about the OPPS payment reduction to account for the 340B budget neutrality adjustment, pp. 33685-93 for information about the application of site neutral payments to hospital outpatient drug administration services and pp. 33653-54 and pp. 33832-33 for information about the hospital drug acquisition cost survey.

Reduction in OPPS payment rates for most items and services

The proposed OPPS payment reductions to recoup a portion of the 340B lump sum payments are the result of the prior 340B payment cuts being implemented in a “budget-neutral” manner. [...]

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This Week in 340B: July 8 – 14, 2025

by Emily Jane Cook, Matthew David, Margaret Houtz, Jae Hyun Lee, Deepika Raj, Kelsey Reinhardt and Nadine Tejadilla | Jul 16, 2025 | 340B

Find this week’s updates on 340B litigation to help you stay in the know on how 340B cases are developing across the country. Each week we comb through the dockets of more than 50 340B cases to provide you with a quick summary of relevant updates from the prior week in this industry-shaping body of litigation. Get more details on these 340B cases and all other material 340B cases pending in federal and state courts with the 340B Litigation Tracker.

Issues at Stake: Rebate Model; Contract Pharmacy;

In five appealed cases related to rebate models:
- In five cases, the appellant filed its brief.
- In three cases, the plaintiff-appellants filed a reply in support of their emergency motion to dismiss the cross-appeals.
In one case challenging a state law in Tennessee, the defendant filed a response in opposition to the plaintiff’s motion for preliminary injunction, and the plaintiff filed a memorandum in opposition to the defendant’s motion to dismiss; and in a second case, the defendant filed a motion to dismiss.
In a case challenging a South Dakota bill, amici filed a brief in support of the government’s motion to dismiss.
In two cases challenging Nebraska’s state law governing contract pharmacy arrangements, the court granted amici’s motion for leave to submit a brief of amicus curiae and, in a second case, the defendant filed a motion to dismiss.
In one case challenging Missouri’s state law governing contract pharmacy arrangements, the court dismissed without prejudice [...]

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5 Questions with a Health Lawyer: Charles Buck

by McDermott Will & Emery | Jul 11, 2025 | Uncategorized

Charles (Charlie) Buck 
Practice Focus Area: Health Industry Advisory; Hospitals and Health Systems
Office: Boston
Years at Firm: 22+ years

What is your favorite part of practicing healthcare law at McDermott?
Healthcare is a complicated, heavily regulated industry. Government is also the primary payor in the industry. As a result, lawyers with deep knowledge and experience are absolutely critical members of the strategic leadership team for any health care organization. I like helping clients (often hospitals and health systems) navigate these complicated waters so they can meet their ultimate strategic goal of improving patient care.

What is the biggest opportunity and greatest challenge facing clients in your area of focus today?
The rapid pace of change presents challenges and opportunities. Inertia is a powerful force in healthcare, and it leads to inefficiency and frustration. There are real opportunities to improve our healthcare system, but there are also real risks for organizations that invest in the wrong strategies. It is a crowded field, and it will be a challenge to identify and remain focused on the best strategies for improvement.

What advice would you give to junior lawyers looking to build their practice in your focus area?
Learn as much as you can about the industry. It is impossible to be a good healthcare lawyer without a deep understanding of the healthcare industry – an odd and idiosyncratic industry sector.

What is the proudest moment of your career [...]

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This Week in 340B: July 1 – 7, 2025

by Emily Jane Cook, Reuben Bank, Matthew David, Jae Hyun Lee, Margaret Houtz, Deepika Raj, Kelsey Reinhardt and Nadine Tejadilla | Jul 9, 2025 | 340B
Find this week’s updates on 340B litigation to help you stay in the know on how 340B cases are developing across the country. Each week we comb through the dockets of more than 50 340B cases to provide you with a quick summary of relevant updates from the prior week in this industry-shaping body of litigation. Get more details on these 340B cases and all other material 340B cases pending in federal and state courts with the 340B Litigation Tracker.

Issues at Stake: Rebate Model; Other; HRSA Audit Process; Contract Pharmacy

In five appealed cases related to rebate models:

In four cases, an amended amicus brief was filed in support of the appellant drug manufacturers.

In one case, a motion to consolidate was filed.

In one case, the intervenor-appellees filed a response to appellant’s motion to dismiss their cross-appeal.

In a case by a covered entity against an insurance company alleging breach of contract, the insurance company filed a motion to dismiss and memorandum in support of its motion to dismiss.

In a case by a covered entity challenging the government’s decision to allow a manufacturer’s audit, the government filed a reply in further support of its motion to dismiss.

In a case challenging a South Dakota bill, the court granted leave to file an amici curiae brief in support of the government.

In four cases challenging a Utah bill, the government filed motions to dismiss and memoranda in support of their motions [...]

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This Week in 340B: June 24 – 30, 2025

by Emily Jane Cook, Matthew David, Margaret Houtz, Jae Hyun Lee, Deepika Raj and Kelsey Reinhardt | Jul 2, 2025 | 340B
Find this week’s updates on 340B litigation to help you stay in the know on how 340B cases are developing across the country. Each week we comb through the dockets of more than 50 340B cases to provide you with a quick summary of relevant updates from the prior week in this industry-shaping body of litigation. Get more details on these 340B cases and all other material 340B cases pending in federal and state courts with the 340B Litigation Tracker.

Issues at Stake: Other; Rebate Model; Antitrust; Contract Pharmacy; GPO Prohibition

In a case by a covered entity against the government, the court denied the covered entity’s motion for preliminary injunction.

In four appealed cases against the government related to rebate models, the appellants filed an emergency motion to dismiss the cross appeals by intervenor-defendants, and four amicus curiae briefs were filed in support of the appellants.

In a case challenging a state Medicaid 340B carve-out plan, the court entered a stipulation of discontinuance without prejudice.

In one case against the government related to rebate models, the court issued its opinion which the plaintiff appealed, five amicus curiae briefs were filed in support of the plaintiff and two amicus briefs were filed in support of the defendants.

In an antitrust class action case, the defendant filed a reply memorandum in support of its motion to dismiss the plaintiff’s amended complaint.

In one case challenging a state law in Tennessee, the court denied the plaintiff’s motion for [...]

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