CMS Requiring All 340B Entities to Use Claims Modifiers When Billing Part B for 340B Drugs

CMS
CMS is requiring all 340B covered entities by Jan. 1, 2024, to use claims modifiers to identify drugs as having been purchased through 340B when they bill for separately payable Medicare Part B drugs.

The U.S. Centers for Medicare & Medicaid Services starting Jan. 1, 2024, will require all 340B covered entities—hospital and grantee—to use claims modifiers to identify drugs as having been purchased through 340B when they bill for separately payable

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Hospital Groups and Brand Drug Industry React to Wall Street Journal’s 340B Hospital Investigation

WSJ
340B hospitals defended themselves and the program in the wake of a highly critical Wall Street Journal investigation, while the drug industry said the story revealed “abuse that policymakers can no longer ignore.”

Groups that represent 340B hospitals are defending the drug discount program and their role in it in response to a Wall Street Journal article Tuesday that raised questions about how some hospitals qualify for and use the program.

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Top Referral Specialties And Medications Driving 340B Savings

Don Holladay and Stephanie Caiazzo of Cloudmed

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Cloudmed routinely analyzes aggregate data to identify 340B program trends and patterns that can provide useful client insights regarding referral prescriptions. Our 340B team observed two calendar years of data across more than 230 covered entity sites to understand which drugs, therapeutic classes, and medical specialties account for the largest savings realized through referral prescriptions within the contract pharmacy domain.

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Viatris Providing Credits Due to Problem that Made 340B Pricing Unavailable in August

Viatris
Viatris says it will give credits for drug purchases at higher than 340B ceiling price during early August, when a problem during a system transition made 340B prices unavailable to some entities.

Drug manufacturer Viatris will give 340B covered entities credits on requests for purchases of dozens of NDCs at higher than 340B ceiling price during the first 11 days of August, the company says in a notice on the

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Private Oncologist Group-Funded Study Models Effects of Using CMS’s Controversial 2020 340B Hospital Drug Cost Survey

Avalere
A new study models what would happened in 2023 if Medicare paid 340B hospitals for physician administered drugs based on a survey of those hospitals’ drug acquisition costs taken during the COVID pandemic’s darkest days in 2020.

Private practice oncologists have paid for a study to model what would happened in 2023 if Medicare paid 340B hospitals for physician administered drugs based on a survey of those hospitals’ drug acquisition costs taken during the COVID

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Our Top 10 Breaking News Stories of 2022

Top 10
A judge’s decision in February to vacate the federal government’s letter telling AstraZeneca its 340B contract pharmacy policy is illegal was our top breaking news story of 2022.

A judge’s decision in February to vacate the federal government’s letter telling AstraZeneca its 340B contract pharmacy policy is illegal was our top breaking news story of 2022.

Number two on the list (based on how often a

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Breaking News

Wall Street Journal Says Its Investigation of 340B Hospitals Raises Questions about Program’s Growth and Purpose

The Wall Street Journal's long article today about hospital participation in 340B comes three months after a similar lengthy critique by The New York Times.

A growing number of hospitals that do not qualify for 340B drug discounts as disproportionate share hospitals are enrolling instead under less demanding criteria for rural referral centers—including nationally prominent urban hospitals in metro Boston, Chicago, and Cleveland,

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Breaking: Congress Wants HRSA Briefing on Action to Safeguard 340B Entities’ “Lawful Access to Discounted Drugs”

Senate Appropriations
The U.S. Senate Appropriations Committee released an omnibus FY 2023 spending bill late yesterday with report language requesting a HRSA briefing on its actions to safeguard providers' access to 340B drug discounts.

U.S. House and Senate appropriations committees want federal healthcare officials to brief them by April “on actions taken to safeguard covered entities’ lawful access to discounted drugs” under the 340B program.

The directive to the Health Resources and

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Amgen Sues HHS in Defense of the Company’s 340B Contract Pharmacy Restrictions

Amgen
Amgen yesterday sued HHS and HRSA in defense of its conditions on 340B pricing when hospitals use contract pharmacies.

Biopharmaceutical manufacturer Amgen yesterday became the 10th drug manufacturer to sue the federal government over the government’s position that the 340B statute requires drug companies to provide 340B-priced drugs to multiple contract pharmacies without conditions.

California-based Amgen

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Merck Providing Refunds for 340B Overcharges During Q4 2019, Q3 2021, and Q2 2022

Merck
Merck is providing refunds for 340B overcharges during Q4 2019, Q3 2021, and Q2 2022.

Drug manufacturer Merck is providing refunds for charges above 340B ceiling prices on 23 NDCs purchased during Q4 2019, Q3 2021, and Q2 2022.

The U.S. Health Resources and Services Administration posted Merck’s Nov. 21 notice about the

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