The Eighth Circuit agreed with the district court that the manufacturer was unlikely to prevail on the ultimate merits of its claims, as any extraterritorial effect of the statute was negligible and nondiscriminatory toward out-of-state entities. The court also rejected Novartis’ attempt to revisit its previous stance on federal preemption.

The case will be remanded to the district court for further proceedings on the merits.

The court granted a preliminary injunction that prevents the department from implementing the rule Wednesday, July 1. As grounds, the judge found that the department’s definition of professional degree more stringent than the statutory text of H.R. 1. A similar lawsuit filed by several Democratic state attorneys general remains pending.

The lawsuit was brought by 20 state attorneys general. Other challenges to the policy are pending, and the federal government has stated its intent to appeal the ruling.

MHA members may take advantage of a class action settlement service, on a contingent fee basis, through our partnership with MCAG.

As a reminder, the deadline for MCAG to file a claim on behalf of a hospital for the $1.2 billion Discover Financial Services mishandling of commercial accounts is Monday, May 18.

For those not contracted with MCAG and wish to do so, visit its website for MHA members and complete the electronic enrollment form. Additional details are available.

The American Hospital Association and several 340B covered entities successfully challenged the program in the U.S. District Court for the District of Maine, where the court ruled that the agency’s decision to launch the rebate program was arbitrary and capricious for failing to consider and reasonably explain its impact on hospitals. 

On appeal, the First Circuit ruled that HHS failed to demonstrate sufficient likelihood of success on the ultimate merits of the case, a necessary element to granting a stay.

HHS also has appealed entry of the injunction on the merits, which will be adjudicated by the First Circuit following briefing and argument by the parties.

Contrary to its previous interpretation of the statute, CMS promulgated a rule in 2024 that barred private mitigation arrangements among providers and required states to collect provider attestations denying participation in an unlawful mitigation arrangement beginning in 2028.

The court held CMS’ interpretation was contrary to the statutory text and arbitrary and capricious. It also nullified a provision in the rule that required recoupment actions against a state for allowing such arrangements to be heard by an administrative board instead of the courts.

In his order dismissing the case, Judge Clark concluded that AbbVie’s grievance is with the replenishment model used by covered entities and contract pharmacies to provide discounted drugs to patients. The provisions of SB 751 do not address AbbVie’s issues with the replenishment model; therefore, they could not demonstrate an injury fairly traceable to the legislation.

Judge Clark granted AbbVie until Friday, July 25, to file for leave to amend its complaint.

Three cases challenging SB 751 remain. Novartis appealed the denial of its request for a preliminary injunction to the Eighth Circuit Court of Appeals and filed its initial brief. The parties currently are engaged in discovery in the lawsuits brought by AstraZeneca and the Pharmaceutical Research and Manufacturers Association.

The day after is probably less familiar for many individuals. However, April 16 is just as, if not more, important; it’s National Healthcare Decisions Day.  

NHDD serves as an initiative that encourages people to either start or continue having conversations about their wishes for care at the end of life.  

Founded in 2008 by attorney Nathan Kottkamp, NHDD is built around the idea that just like filing taxes, reviewing your health care preferences should be an annual habit because circumstances, relationships and preferences can change throughout your life. 

In fact, April 16 was chosen as NHDD based on the Benjamin Franklin quote, “In this world, nothing is certain except death and taxes.” So, this year, once your taxes are filed, start the conversation about your health care wishes or review them with your loved ones and health care team. 

Advance care planning 

If you woke up in a hospital one day and couldn’t talk, who would speak for you? If you couldn’t breathe or swallow, what care would you want? How would you let your doctor know your wishes? 

All people hope they can communicate until the end of their lives, but unfortunately, that’s not always the case. Without a plan in place beforehand, your family and care team won’t know how you want to be treated, or even if you wish to be treated. 

Advance care planning includes making your health care wishes known, which can be done in several different ways. 

• An advance directive appoints a person to speak for you and contains your preferences for medical treatment. Each state has its own advance directive. CaringInfo, a program of the National Alliance for Care at Home, offers free advance directives and instructions for Missouri residents. 
• A living will states the type of care you prefer if you’re not able to speak for yourself.  
• A durable power of attorney for health care and health care directive is a legal document that appoints and authorizes someone to speak for you when you cannot. This document must be witnessed or notarized. The Missouri Bar offers a free form available online for people to complete their durable power of attorney for health care and health care directive. 
• A Do Not Resuscitate order includes medical orders written by a doctor. They instruct health care providers not to perform cardiopulmonary resuscitation if a patient’s breathing or heart stops. 
• A Physician’s Order for Life-Sustaining Treatment consists of a set of medical orders that applies to a limited population of patients, such as seriously ill or frail people, and addresses a limited number of critical medical decisions. 

Making difficult conversations easier 

The theme of NHDD for 2025 is “Talk about it.”  

While it’s not easy to discuss end-of-life care, The Conversation Project, an initiative of the Institute for Healthcare Improvement, offers tips and advice to help people have conversations about their health care wishes.  

The Conversation Project also offers resources for spreading the word about NHDD or planning events in honor of the day.