Justia Health Law Opinion Summaries

Plaintiff filed suit against GBMC, seeking to recover funds to Medicare and to collect for herself under the Medicare Secondary Payer Act, 42 U.S.C. 1395y, which authorizes a private cause of action for double damages where a recalcitrant payer "fails" to reimburse Medicare. Sixteen days after plaintiff filed the federal suit, GBMC paid her $403,722.24, which represented the amended final judgment amount plus post-judgment interest. The Fourth Circuit affirmed the district court's grant of GBMC's motion for summary judgment, holding that, although plaintiff was injured when GBMC was obligated under law to pay for her medical care but did not, GBMC did not fail to reimburse plaintiff because its payment was well within plaintiff's proposed deadline. View "Netro v. Greater Baltimore Medical Center, Inc." on Justia Law

In 2017, Maryland enacted “An Act concerning Public Health – Essential Off-Patent or Generic Drugs – Price Gouging – Prohibition.” The Act, Md. Code, Health–General 2-802(a), prohibits manufacturers or wholesale distributors from “engag[ing] in price gouging in the sale of an essential off-patent or generic drug,” defines “price gouging” as “an unconscionable increase in the price of a prescription drug,” and “unconscionable increase” as “excessive and not justified by the cost of producing the drug or the cost of appropriate expansion of access to the drug to promote public health” that results in consumers having no meaningful choice about whether to purchase the drug at an excessive price due to the drug’s importance to their health and insufficient competition. The “essential” medications are “made available for sale in [Maryland]” and either appear on the Model List of Essential Medicines most recently adopted by the World Health Organization or are “designated . . . as an essential medicine due to [their] efficacy in treating a life-threatening health condition or a chronic health condition that substantially impairs an individual’s ability to engage in activities of daily living.” The Fourth Circuit reversed the dismissal of a “dormant commerce clause” challenge to the Act, finding that it directly regulates the price of transactions that occur outside Maryland. View "Association for Accessible Medicine v. Frosh" on Justia Law