California Still Plans to Move Medicaid Pharmacy Benefits to Fee-for-Service in January

California’s Medicaid (Medi-Cal) program remains on track to move its pharmacy benefit from managed care to fee-for-service early next year.

UPDATE Tuesday, Oct. 26, 2021, 5:00 p.m. EDT—We have updated this article to reflect new information from the California Department of Health Care Services (DHCS) about the timeframe for the U.S. Centers for Medicare & Medicaid Services (CMS) to

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Drug Manufacturers May Seek Orphan Designations to Avoid Paying 340B Discounts, HHS OIG Concludes

The 340B orphan drug exclusion incentivizes manufacturers to get orphan designations for drugs approved to treat common diseases or conditions, a new government report says.

The ban on 340B discounts on orphan drugs for rural and free-standing cancer hospitals may give drug companies a powerful incentive “to seek orphan designation for drugs approved to treat common diseases or conditions,” the U.S. Health and Human

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340B Providers Might Insure HIV-at-Risk Patients in Response to Gilead’s PrEP Reimbursement Cuts

340B covered entities are bracing for a huge reimbursement cut due to start in January for Gilead pre-exposure prophylaxis (PrEP) medications.

340B covered entities are exploring buying health insurance for patients at risk of contracting HIV in response to a huge reimbursement cut due to start in January for Gilead pre-exposure prophylaxis (PrEP) medications.

Gilead announced in April

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Parties at Center of Contract Pharmacy Standoff React to HHS OIG Referral

HRSA's decision to refer six drug manufacturers to the HHS OIG has elicited a variety of reactions.

The decision by the U.S. Health Resources & Services Administration (HRSA) to refer six drug manufacturers to the U.S. Health and Human Services Department of the Office of The Inspector General (HHS OIG) for refusing to offer 340B discounts

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Hospitals Urge CMS To Abandon Medicare Part B Cuts While PhRMA Presses For More Action

Hospital trade groups have lodged strong objections to CMS's proposal to maintain deep Medicare Part B reimbursement cuts, while PhRMA is suggesting even further 340B reforms.

Hospital trade groups are lodging strong objections to maintaining steep cuts in Medicare Part B drug reimbursement as part of the Fiscal Year 2022 final rule for the hospital outpatient prospective payment system (OPPS), while the trade group for

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Breaking News

Breaking: HRSA Refers Six Drug Companies to HHS OIG For Refusing to Offer Discounts

HRSA has referred six drug manufacturers to the HHS Office of Inspector General for refusing to offer 340B discounts in the contract pharmacy setting.

The U.S. Health Resources & Services Administration (HRSA) today referred six drug manufacturers to the U.S. Health and Human Services Department of the Office of the Inspector General (HHS OIG) regarding their refusal to offer 340B discounts to 340B

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U.S. Supreme Court Schedules Oral Arguments on 340B Reimbursement Case

The Supreme Court’s decision to hear the case over Medicare-related 340B cuts to hospitals surprised many observers. Oral arguments are scheduled for Nov. 30, with a decision not likely until the spring.

The U.S. Supreme Court has announced the cases it will take up this fall and 340B will be on the plate. The court recently posted its hearings schedule for the months of October through December and will hear

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As Hospital Recertification Deadline Nears, 340B Eligibility Challenges Appear Not to Be Widespread for Now

The COVID-19 pandemic’s impact on hospitals’ eligibility for 340B could become an issue beginning later this year, industry observers say.

With the deadline for hospitals to recertify their eligibility for 340B drug discounts arriving on Monday, it appears most facilities will remain qualified—at least for now.

Industry observers say the COVID-19 pandemic’s impact on hospitals’ eligibility for 340B

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Merck Defends and Hospitals Slam the Company’s Tougher 340B Contract Pharmacy Policy

Drug manufacturer Merck is defending and hospital groups are condemning the drug company's decision to impose mandatory conditions on 340B pricing when hospitals use contract pharmacies.

Drug manufacturer Merck says it is imposing mandatory conditions on 340B pricing when hospitals use contract pharmacies due to “very low” participation in its voluntary 340B program integrity initiative.

Groups that represent hospitals in the drug discount program

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Distressed Critical Access Hospitals that Devolve to Stay Open Would Lose 340B Eligibility

A new federal law to help financially distressed rural hospitals stay open in a reduced capacity would not preserve the hospitals’ eligibility for 340B drug discounts.

A new federal law to help financially distressed rural hospitals stay open in a reduced capacity would not preserve the hospitals’ eligibility for 340B drug discounts.

Federal spending legislation that President Trump signed into law last Dec. 27

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