The issue focused on doctors treating patients who lack insurance coverage for drugs such as tamoxifen and antibiotics used to treat tuberculosis. Some critics argued that Medicare funding should not have been withheld because Medicaid recipients cannot afford prescription drugs. The lawsuit argues that medical providers must reimburse Medicare based on profit margins rather than profits earned through innovation.

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Congress approved federal reimbursement caps at 100 percent of revenue during the fiscal year ending Sept. 30. Under current law, payments would rise gradually each year until reaching 50 percent