Tom Mirga

New Part B Drug Claims Modifier Requirement for 340B Entities Starts Jan. 1

December 7, 2023

Tom Mirga Editor at Large Views

A CMS policy that requires 340B covered entities to use new Medicare Part B drug claims modifiers will take effect Jan. 1.

Critical access hospitals (CAHs) and Ryan White HIV/AIDS clinics do not expect problems implementing a new requirement starting Jan. 1, [...]

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N.Y. State, Health Centers Seek Brief Pause in Medicaid Drug Benefit Lawsuit

November 30, 2023

Tom Mirga Editor at Large Views

The parties involved in a legal challenge over certain Medicaid managed care drug benefits have jointly asked for a pause in proceedings.

Both sides in a lawsuit over New York state’s transfer of Medicaid managed care drug benefits to Medicaid fee for [...]

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340B Provides Benefits, Needs Reform, Says Literature Review

November 28, 2023

Tom Mirga Editor at Large Views

A JAMA Health Network literature review found that the 340B program provides a range of benefits but needs reforms.

The 340B program has provided a range of benefits but also needs reforms, according to a recent review of published [...]

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340B’s Footprint in Medicare Part D Is Growing, Study Says

November 28, 2023

Tom Mirga Editor at Large Views

A JAMA Health Forum study co- authored by Sean Dickson found the 340B program's footprint in Medicare Part D is increasing.

340B covered entities captured nearly half (49.9%) of their 340B-eligible prescriptions billed to Medicare Part D in 2020, up from [...]

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Two Drugmakers Offer Refunds for 340B Overcharges

November 28, 2023

Tom Mirga Editor at Large Views

Two drugmakers, Mallinckrodt's subsidiary SpecGx and Novo Nordisk, owe refunds to 340B providers for certain overcharges.

Two drugmakers will offer refunds to 340B providers for overcharges in recent years. Drug manufacturer Mallinckrodt’s SpecGx generic pharmaceutical subsidiary [...]

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Apexus Asks Appeals Court to Affirm Dismissal of Contract Breach Lawsuit

November 17, 2023

Tom Mirga Editor at Large Views

Apexus asked the 9th U.S. Circuit Court of Appeals to dismiss a lawsuit claiming it failed to negotiate sub-340B ceiling price discounts on HIV/AIDS drugs.

Apexus, the 340B prime vendor, asked a federal appeals court to affirm a lower court’s dismissal of claims that it [...]

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Hospitals to Meet with White House, HHS About 340B Dispute Resolution Process

November 15, 2023

Tom Mirga Editor at Large Views

Hospital groups will meet with the White House to discuss coming changes to the 340B administrative dispute resolution process.

Hospital groups will meet with federal executive branch officials to discuss coming changes to the 340B program’s administrative dispute resolution [...]

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HRSA, Hospital Settle Lawsuit Over Termination from 340B

November 7, 2023

Tom Mirga Editor at Large Views

The hospital Insight Chicago and federal regulators have agreed to dismiss a case before a federal district court over the hospital's 340B eligibility.

A federal district judge in Illinois has dismissed a Chicago hospital’s apparently successful lawsuit challenging its termination from the 340B [...]

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Senate Finance Committee Republicans Oppose CMS Plan to Redefine Medicaid Best Price

November 7, 2023

Tom Mirga Editor at Large Views

A group of Republicans on the Senate Finance Committee have called on CMS to withdraw its plan to rewrite the definition of Medicaid best price.

A group of Senate Republicans recently urged federal regulators to withdraw a plan to change the definition of a drug’s [...]

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Federal Judge Strikes Down 340B Patient Definition

November 3, 2023

Tom Mirga Editor at Large Views

Genesis Health Care successfully challenged HRSA's 340B patient definition in the U.S. District Court for the District of South Carolina.

A federal district judge in South Carolina late today struck down the 340B program’s patient definition, as federal regulators described [...]

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