Southwest Pharmacy Solutions, Inc., a pharmacy cooperative association made up of over 500 independent pharmacies participating in the Medicare program, sued the Centers for Medicare and Medicaid Services (CMS) alleging that the preferred pharmacy rule, 42 C.F.R. § 423.120(a)(9) (Preferred Pharmacy Rule), violated the Medicare Act’s “any willing pharmacy” provision, 42 U.S.C. § 1395w-104(b)(1)(A). Because Southwest failed to exhaust its administrative remedies, CMS moved to dismiss Southwest’s claims for lack of jurisdiction and the court granted CMS’s motion.
No Judicial Review Until Administrative Remedies are Exhausted
Availability of Judicial Review
Southwest Can Use a Proxy
Sufficient Incentives for Southwest’s Proxies to Ensure Southwest’s Claims are Heard
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