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Articles by : Rich Daly, Editor in Chief

Do 340B Lump Sum Payments Underscore Need for More Transparency or Are They Unrelated?

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Peter Pitts
Peter Pitts, president of the Center for Medicine in the Public Interest, says the recently released 340B Medicare lump sum payments underscore the need for more 340B program transparency.
A recently proposed list of planned Medicare payments for individual 340B hospitals is seen as ammunition to some 340B critics. [...]

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Amid Historic Financial Challenges, 340B Proposed Payments Will ‘Make a Difference’ for Some Hospitals’ Budgets, Says Rating Official

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Fitch Ratings webinar
A Fitch Ratings webinar on the not-for-profit hospital sector discussed the financial implications of the proposed $9 billion lump sum Medicare payment to make up for five years of illegal 340B cuts.
As the not-for-profit hospital sector slowly emerges from its worst financial year in recent history, some of those organizations’ bottom [...]

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Broad Support Emerges for Adding Duplicate Discount Modifiers to Medicaid Cards

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CMS duplicate discounts
340B stakeholders broadly support adding identifiers to Medicaid drug beneficiaries’ cards to held avoid duplicate 340B discounts, comments on a CMS proposed rule show.
A federal proposal to require the addition of new identifiers to Medicaid drug beneficiaries’ cards to avoid duplicate 340B discounts [...]

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CMS’s 340B Hospital Repayment Plan Leaves Medicare Advantage Cuts Untouched

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Attorney Kyle Vasquez
Attorney Kyle Vasquez says many clients feel they are entitled to a remedy for underpayments from Medicare Advantage plans stemming from CMS' July 7 proposed rule.
The recently proposed Medicare fee-for-service lump sum payments to 340B hospitals to make up for a nearly five-year unlawful rate [...]

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NY FQHCs Receive $135 Million to Offset State’s 340B Medicaid Shift, While Other Providers Wait

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Medicaid NYRx
New York health centers are getting $135 million this week to partially replace revenue providers lost when the state implemented an April 1 shift of its Medicaid managed care drug benefits to Medicaid FFS, called NYRx.
Federally qualified health centers in New York received $135 million lump sum payments this week to partially offset expected 340B [...]

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Judge Rejects 340B Provider Challenge to California Medicaid Drug Payment Shift

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U.S. District Court Sacramento
A federal district judge in Sacramento, Calif., dismissed a lawsuit on July 17 aimed at reversing the state’s transfer of Medicaid managed care drugs benefits to Medicaid fee for service.
A federal district judge in Sacramento, Calif., recently dismissed a lawsuit aimed at reversing the state’s January 2022 transfer of [...]

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Medicare Part B Keeping Default Pay Rate for 340B Drugs, Says OPPS Proposed Rule

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CMS
Medicare Part B plans to continue paying average sales price plus 6% for for 340B acquired drugs and biologicals in 2024, the U.S. Centers for Medicare & Medicaid Services said July 13.
Medicare Part B plans to continue paying the statutory default rate—generally average sales price plus 6%—for 340B acquired drugs and [...]

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UPDATED: Contract Pharmacy Restrictions Cut $1.5 Billion in 340B Hospital Revenue, $8.4 Billion More Endangered, Report Says

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340B Health study
Drug manufacturers' 340B contract pharmacy restrictions have pulled $8.4 billion out of the savings hospitals achieve using contract pharmacies to dispense 340B drugs, a new 340B Health study found.
Early, limited versions of contract pharmacy restrictions for 340B hospitals cut their revenue by $1.5 billion in one year, according [...]

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Some 340B Hospitals Might Get Less Than Expected Under Fix for Illegal Medicare Drug Payment Cuts

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Spreadsheet
CMS's projections of what it owes 340B hospitals for unlawful Medicare Part B drug payment cuts might not align with what health systems and hospitals expect to get.
A $9 billion Medicare proposal to repay 340B hospitals for unlawful Part B drug payment cuts includes a spreadsheet showing [...]

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Providers Celebrate 340B Medicare Drug Payment Fix, Object to How It’s Funded

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Federal Register
CMS today formally published in the Federal Register its proposed remedy for illegal Medicare Part B drug payments cuts for many 340B hospitals from 2018 through 2022.
Provider groups widely celebrated the Medicare proposal to provide a $9 billion lump sum payment to reimburse 340B hospitals for [...]

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