340B hospitals’ Medicare Part B payment challenge is not the only Supreme Court case next term that will impact the 340B program.

Biden Administration Position in Supreme Court ACA Case Has 340B Implications

The Biden administration late yesterday told the U.S. Supreme Court that, due to the change in the presidency, the federal government has changed its main position in the lawsuit over the Affordable Care Act’s (ACA) constitutionality. The government now says the court should uphold the entire law.

If the Supreme Court were to decide that the entire ACA was unconstitutional, all of its 340B related provisions would be struck down. These include deeper 340B discounts (due to ACA’s higher Medicaid drug rebate percentages), extension of 340B eligibility to rural and free-standing cancer hospitals, the fight over responsibility for preventing duplicate 340B discounts and Medicaid managed care rebates, the new 340B administrative dispute resolution process, and manufacturer civil monetary penalties for knowing and intentional overcharges.

The Trump administration argued in the case that ACA’s individual insurance mandate is unconstitutional and, that as a result, the entire ACA is unconstitutional. In taking that stance, the Trump administration sided with the several red states that filed the lawsuit.

The Supreme Court heard arguments in the case in on Nov. 10. Although it could hand down its decision at any time, it habitually releases it biggest decisions toward the end its term, which should come in June or early July.