Associations representing community health centers and brand drug manufacturers are jointly developing 340B policy proposals for Congress to consider, hospital group 340B Health told its members yesterday.
The National Association of Community Health Centers said yesterday that it had no comment. Pharmaceutical Research and Manufacturers of America also said it had no comment.
According to 340B Health members, the hospital group said in a March 1 email to its members that NACHC and PhRMA have been working together on several major 340B recommendations to Congress, potentially including new hospital eligibility requirements and new reporting requirements for all or most covered entities. 340B Health members said the group expressed concern in the email about reduced 340B drug discounts and its effect on patient care.
Senate HELP hearing today
The U.S. Senate Health, Education, Labor, and Pensions Committee is holding a hearing on health centers this morning. Their dependence on 340B revenues is expected to come up. Late yesterday, HELP Ranking Republican Bill Cassidy (La.) asked the Government Accountability Office for a comprehensive study of health center funding “to understand the health of the program and ensure proper stewardship of American taxpayer dollars.”
Cassidy asked for information on the various revenue streams of health centers to understand how the program is currently operating. Cassidy also asked GAO for an overview of federal funding for health centers during the COVID-19 pandemic, including COVID-19 related legislation and the American Rescue Plan Act.
Cassidy said in a news release, “GAO’s most recent review from 2019 indicates that revenue for CHCs has doubled between 2010 and 2017 with Medicaid, Medicare and private payments making up a larger percentage of that total.” Cassidy told GAO that he hopes the agency can “prioritize this project as we will look to it as we reauthorize the program by the end of this fiscal year.” HELP Committee Chairman Bernie Sanders (I-Vt.) said in a news release about the hearing, “I will be doing everything I can to expand community health centers so that every American has access to the primary care that they need and deserve.”
Cassidy, a gastroenterologist who has worked at a public hospital in Louisiana, is a longtime critic of some 340B hospitals and has introduced legislation in previous sessions of Congress to scale back the 340B program.
Sue Veer, President and CEO of Carolina Health Centers in Greenwood, South Carolina is one of the scheduled witnesses. She serves on NACHC’s board and is leading voice and expert on the 340B program. Amanda Pears Kelly of Advocates for Community Health, a newer, smaller health center association, also is testifying. ACH wants Congress to create a separate drug discount program called 340C open to health centers and perhaps rural hospitals and other federal grantees.
NACHC’s P&I Forum getting underway
NACHC’s annual Policies & Issues Forum in Washington, D.C., begins March 8th with the group’s second annual 340B Day occurring on March 10th. NACHC members will be on Capitol Hill Thursday March 9 lobbying lawmakers and their staffs.
Last summer, a federal 340B administrative dispute resolution panel dismissed NACHC’s claims that AstraZeneca and Sanofi’s conditions on 340B pricing involving the contract pharmacy program resulted in illegal overcharges. NACHC said in a September statement and an October letter to U.S. Health and Human Services Secretary Xavier Becerra that the ADR panel’s “inexplicable” decision left it “little choice but to go to Congress.”
NACHC also supports the 340B PROTECT Act, which would protect covered entities from discriminatory reimbursement and other practices by pharmacy benefit managers and establish a neutral third party claims data clearinghouse to protect drug manufacturers from giving Medicaid rebates and 340B discounts on the same drugs. The bill has not yet been reintroduced in the current session of Congress.
At the last two 340B Coalition national conferences, 340B Health President and CEO Maureen Testoni has indicated her organization would consider a legislative solution to the contract pharmacy impasse. At the most recent Coalition conference in August, she said: “if one of the pathways to a solution for this problem involves federal legislation, we will be prepared to pursue it.”
340B Health and other hospital groups, however, have not called for such legislation to date. The next 340B Coalition meeting will be held late this month in San Diego. It is not known how hospital groups and other covered entity groups will respond to PhRMA’s reported cooperation with NACHC.
PhRMA has said before that policymakers should:
- ensure that patients benefit more directly from providers’ 340B discounts
- clarify the 340B patient definition “to ensure needy patients are truly benefitting”
- implement 340B hospital transparency requirements
- increase oversight of covered entity compliance with 340B requirements to ensure that the program “directly benefits vulnerable or uninsured patients”
- reconsider the 340B contract pharmacy policy.
