Court rules against government on drug reimbursement
By Jessica Gresko
Associated Press
WASHINGTON (AP) — The Supreme Court said Wednesday that the federal government improperly lowered drug reimbursement payments to hospitals and clinics that serve low-income communities, a reduction that cost the facilities billions of dollars.
The high court ruled unanimously in a case involving payments for drugs, largely for cancer, that are used by Medicare patients in hospital outpatient departments. The Biden administration had stood by a Trump administration decision to reduce the payments.
The government had said that the hospitals and clinics, because of their special status serving low-income communities, are able to buy the drugs at a deep discount. The government said reimbursing the hospitals, called 340B hospitals, at the same rate as other hospitals that pay more created an incentive for the hospitals to overprescribe the drugs or prescribe more expensive drugs. It said that lowering the reimbursement would also save Medicare beneficiaries money in co-payments because those are linked to reimbursement rates.
Justice Brett Kavanaugh wrote for the court that "absent a survey of hospitals' acquisition costs" the Department of Health and Human Services "may not vary the reimbursement rates for 340B hospitals. HHS's 2018 and 2019 reimbursement rates for 340B hospitals were therefore contrary to the statute and unlawful."
In a statement, the American Hospital Association and other groups involved in the case called the decision a "decisive victory for vulnerable communities and the hospitals on which so many patients depend." They hope to work with the administration and the courts on a reimbursement plan.
The case before the justices involved Medicare, which provides health insurance for nearly 60 million people age 65 and older or people with certain disabilities. Under Medicare, health care providers get reimbursed by the government for expenses including drugs used in hospital outpatient departments.
Hospitals had been getting reimbursed at a rate based on the average price of the drugs. But in 2018 the Trump administration said that 340B hospitals and clinics, which serve low-income communities, would be reimbursed at a lower rate. That's because 340B hospitals and clinics are entitled to discounts from drug manufacturers that let them buy drugs at a lower cost. The administration cut the reimbursement rate by nearly 30%, an annual decrease to 340B hospitals and clinics of about $1.6 billion.
Affected hospitals sued and a federal judge initially ruled for them, but that decision was reversed by an appeals court.
The case is American Hospital Association v. Becerra, 20-1114.
Justices dismiss immigration case
By Jessica Gresko
Associated Press
WASHINGTON (AP) — The Supreme Court said Wednesday it was wrong to wade into a dispute involving a Trump-era immigration rule that the Biden administration has abandoned, so the justices dismissed the case.
The court had said it would answer the question of whether Republican-led states, headed by Arizona, could pick up the legal defense of the Trump-era "public charge" rule that denied green cards to immigrants who use food stamps or other public benefits.
The high court heard arguments in the case in February and appeared on track to decide it. But in an unsigned, one-sentence opinion Wednesday, the court said it was dismissing the case. That leaves in place a lower court ruling in favor of the Biden administration that the states could not intervene.
Chief Justice John Roberts wrote separately to say he agreed with the decision to toss the case. Roberts said that "bound up" in the case are "a great many issues beyond" the question that the court had agreed to decide. "It has become clear that this mare's nest could stand in the way" of deciding the case "or at the very least, complicate our resolution of that question," he wrote.
Roberts said the court's action should not be taken as "reflective of ... the appropriate resolution of other litigation, pending or future, related to the 2019 Public Charge Rule, its repeal, or its replacement by a new rule."
Roberts was joined by three other justices in the court's conservative majority: Clarence Thomas, Samuel Alito and Neil Gorsuch. Gorsuch was appointed to the court by Trump. The former president's two other nominees, Justice Brett Kavanaugh and Justice Amy Coney Barrett, said nothing.
At the center of the case was a federal law says that green card applicants cannot be burdens to the country or "public charges." The Trump administration significantly expanded the definition, saying the use of public benefits including food stamps or Medicaid could be disqualifying. That led to court challenges, but the Supreme Court allowed the policy to take effect while those continued.
The Biden administration rescinded the rule and has since announced new guidelines. The administration had said that in practice, the government denied green cards to only three people under Trump's rule and that their applications were later reopened and approved. Immigration groups have said the bigger impact of the rule was scaring immigrants, causing them to drop benefits or not enroll in them because of fears doing so could affect their applications to become legal permanent residents.
In addition to Arizona, the states involved in the case were Alabama, Arkansas, Indiana, Kansas, Louisiana, Mississippi, Missouri, Montana, Oklahoma, South Carolina, Texas and West Virginia.
The case is State of Arizona v. City and County of San Francisco, California, 20-1775.
Court rules for American woman in bitter custody dispute
By Mark Sherman
Associated Press
WASHINGTON (AP) — The Supreme Court ruled unanimously Wednesday for an American woman who is involved in a bitter international custody dispute with her Italian husband over their young son.
The high court threw out lower court decisions ordering the return of the boy to Italy despite finding that he would be at "grave risk of psychological harm" because of the father's physical and emotional abuse of the mother. The child, now around 6, has been living in the U.S. with his mother since 2018.
Federal courts in New York ruled that judges must try to return children to their usual country of residence by imposing conditions that would mitigate the risk, under the international Hague Convention on child abduction.
Writing for the Supreme Court, Justice Sonia Sotomayor said judges have ample discretion to refrain from ordering a child returned, if they find "the grave risk so unequivocal, or the potential harm so severe, that ameliorative measures would be inappropriate."
The justices ordered a new look at the case with that discretion in mind.
It's beyond dispute, Sotomayor wrote that the relationship between Narkis Golan, a U.S. citizen, and Isacco Saada, an Italian, "was characterized by violence from the beginning." They met at a wedding in Milan in 2014, were married a year later and had their son a year after that.
"The two fought on an almost daily basis and, during their arguments, Saada would sometimes push, slap, and grab Golan and pull her hair. Saada also yelled and swore at Golan and frequently insulted her and called her names, often in front of other people. Saada once told Golan's family that he would kill her. Much of Saada's abuse of Golan occurred in front of his son," Sotomayor wrote.
There is no evidence Saada was abusive toward the child.
Golan left Italy with the child in 2018 and hasn't returned.
Under the court order the Supreme Court rejected Wednesday, the child would have lived with his mother in Italy and the father would have supervised visits. Saada would not be allowed to have any contact with Golan for a year.
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