340B Hospitals Concerned About New UnitedHealthcare Claims Reimbursement Policy

Starting Aug. 1, for commercial reimbursement, UnitedHealthcare will stop covering evaluation and management claims at hospital-owned outpatient facilities if the claim does not include an additional medical surgical service on the same date of service by the same provider. | Shutterstock

The nation’s largest health insurer is instituting a commercial claims reimbursement policy that that is raising alarms among 340B hospitals. 

Effective Aug. 1, UnitedHealthcare said it will no longer cover evaluation and management (E/M) claims at hospital-owned outpatient facilities

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CMS Seeks Medicare DSH Calculation Change That Could Disqualify Some Hospitals From 340B

CMS's proposed change to the Inpatient Prospective Payment Systems could cause some hospitals to be disqualified from the 340B program.

The U.S. Centers for Medicare & Medicaid Services is proposing a change to the Medicare disproportionate share hospital (DSH) payment methodology that could cause some hospitals in seven states to be disqualified from the 340B program.

Tucked into the more

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CMS Moves to Delay Multiple-Best-Price Rule For Value-Based Drug Purchases

CMS has proposed delaying the effective date of a rule that would allow multiple best prices in value-based drug purchasing arrangements. | Shutterstock

The U.S. Centers for Medicare & Medicaid Services (CMS) has proposed to delay implementing a portion of a regulation encouraging value-based purchasing for drugs in the Medicaid program that may lead to drugs having multiple best prices.

Finalized during the

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Grassroots Group Launches Regional Events to Promote 340B’s Importance

Community Voices for 340B (CV340B) promotes awareness of the 340B program through in-person seminars and webinars.

Community Voices for 340B (CV340B), the first non-profit grassroots organization focused on promoting the importance of the 340B program, kicked off the first of series of regional educational webinars scheduled last week. The event, which was focused on the Northeast

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Much Cheaper PrEP Drugs Could Mean Financial Upheaval for 340B Covered Entities

Broad availability of low-cost generic pre-exposure prophylaxis drugs could significantly reduce 340B covered entities' revenues on billings for PrEP. | Shutterstock

Correction, Tuesday, May 25, 4:50 p.m. ET – Earlier today, we reported that the wholesale acquisition price for some of the generic PrEP products is now less than $30 per pill. The correct price is less than $30 per

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AbbVie Abused Humira’s Orphan Drug Designation, House Panel Says

Rep. Carolyn Maloney (D-N.Y) on Tuesday asked the FTC to investigate whether AbbVie's pricing and business practices broke the law.

A U.S. House committee alleged Tuesday that AbbVie gamed the federal orphan drug program to boost profits for its anti-inflammatory drug Humira—by far, the top-selling medicine in the United States.

Four types of hospitals that participate in the 340B program

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Montana Enacts Expansive Bill Intended to Protect 340B Providers

Montana Gov. Greg Gianforte (R) signed a bill last week forbidding PBMs from reimibursing 340B covered entities and their contract pharmacies less for drugs than other pharmacies.

Montana has passed a law barring pharmacy benefit managers (PBMs) from excluding 340B contract pharmacies from participating in their networks.

SB 395, known as the Montana Pharmacy Benefit Manager Oversight Act, was signed into law last week by

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HHS Asks U.S. Supreme Court to Reject 340B Hospital Request to Hear Medicare Part B Case

HHS has asked the U.S. Supreme Court to decline taking up 340B hospital suit on Medicare Part B reimbursement.

While 340B hospitals eagerly await to see the Biden administration’s plans for Medicare Part B reimbursement, the U.S. Department of Health and Human Services (HHS) last night asked the U.S. Supreme Court to reject an effort by hospital groups to

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Bipartisan Lawmakers Re-Introduce Bill Shielding Hospitals From Lost 340B Eligibility Due to COVID-19

Rep. Doris Matsui (D-CA) has reintroduced a bill to protect 340B hospitals from losing eligibility during COVID-19.

A bipartisan group of six U.S. House members, led by Rep. Doris Matsui (D-CA), have re-introduced a bill that would prevent hospitals from losing eligibility for 340B discounts as a result of the COVID-19 pandemic.

Five of the six types

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Andrea Palm Confirmed as HHS Deputy Secretary

Andrea Palm, the new HHS deputy secretary, was often the person 340B stakeholders met with at HHS when she served in the department during the Obama administration.

The U.S. Senate on Wednesday voted 61-37 to confirm Andrea Palm’s nomination to be deputy secretary for the U.S. Department of Health and Human Services (HHS). Palm voiced support for the 340B program during her confirmation hearing.

Palm’s confirmation still

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