In Surprise Move, Pennsylvania Wants 340B Modifiers on Medicaid Managed Care Drugs

Pennsylvania
Pennsylvania 340B covered entities say they were blindsided by the state's disclosure last week that it wants drug claims billed to Medicaid managed care organizations to include a modifier showing if the prescription was filled with a 340B-purchased drug.

Pennsylvania health centers are upset about what they say was the state Medicaid office’s disclosure without warning last week that, starting July 1, it wants drug claims billed to Medicaid managed care organizations to include a modifier showing if the

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Feds Pass on Asking Full Appeals Court to Reconsider Adverse 340B Contract Pharmacy Ruling and Vacate Enforcement Letters to Three Manufacturers

Third Circuit Court
The federal government opted not to ask a federal appeals court to reconsider its opinion upholding three drug makers' restrictions on 340B pricing when their drugs are shipped to be dispensed by contract pharmacies.

The federal government yesterday decided not to ask all 14 judges on the U.S. Third Circuit Court of Appeals in Philadelphia to review a three-judge panel’s unanimous January opinion upholding AstraZeneca, Novo Nordisk, and Sanofi’s restrictions on 340B pricing when

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Lilly Asks Covered Entity to Promptly Repay “Duplicate 340B/Medicaid Discounts”

Lilly
Eli Lilly is conducting government approved 340B provider audits that for the first time look for certain Medicaid health plan duplicate discounts.

Drug manufacturer Eli Lilly asked a 340B covered entity last week to promptly repay it for “duplicate 340B/Medicaid discounts” and evaluate all Lilly prescriptions that it or its contract pharmacies dispensed for the last three years.

Consultants and attorneys with

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HHS OIG and HRSA Are Mum About 340B Manufacturer Civil Monetary Penalties and Violation Notices

screenshot of HRSA correspondence to stakeholders web page
HRSA and OIG have no comment on the status of drug manufacturer civil monetary penalties and violation letters stemming from denials of 340B pricing to covered entities that use contract pharmacies.

The U.S. Department of Health and Human Services Office of Inspector General said yesterday it has no comment on the status of referrals from the U.S. Health Resources and Services Administration to fine eight drug manufacturers for failing to offer

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HRSA Allows Immediate 340B Enrollment in Mississippi Due to Tornadoes

Tornado damage
Health care providers in Mississippi can enroll in 340B immediately under program flexibilities granted in response to March 24 tornadoes that killed 21.

Health care providers in Mississippi eligible to participate in the 340B program may do so immediately, rather than having to wait for the next normal quarterly registration period July 1-15, federal health officials said yesterday.

Strong tornadoes struck the state

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HRSA Posts Two Drug Manufacturer Notices to 340B Entities

Vtama pharmaceutical product tube
Dermavant Sciences is giving refunds to health care providers that paid above the 340B ceiling price for Vtama, a treatment for plaque psoriasis.

Biopharmaceutical company Dermavant Sciences is giving refunds to health care providers that paid above the 340B ceiling price for Vtama, a non-steroidal cream to treat plaque psoriasis.

The U.S. Health Resources and Services Administration posted Dermavant’s notice to 340B covered

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340B Registration for Second Quarter of 2023 Begins April 1, with COVID Public Health Emergency Set to Expire in May

Q2 340B registration
Q2 2023 registration for the 340B program starts April 1 and is expected to end April 17.

The second quarterly period this year for 340B registration of new covered entities, outpatient facilities, and contract pharmacies will begin Saturday, April 1, and is expected to end on Monday, April 17.

Normally, a quarterly 340B registration period runs from

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CMS Announces First Drugs Subject to Medicare Inflation Rebates, Issues Guidance Addressing 340B and Medicare Negotiated Drug Prices

CMS building
CMS said planned Medicare Part B premium increases are partly the result of the proposed lump sum payment for previous illegal 340B hospital cuts.

The U.S. Centers for Medicare & Medicaid Services Tuesday announced the first 27 prescription drugs that will be subject to Medicare Part B inflation rebates, a list that includes AbbVie’s blockbuster arthritis drug Humira, which generated $5.6 billion in global

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Amneal Offering 340B Refunds on Long List of Drugs for Sales Between Q3 2019 and Q3 2022

Amneal wordmark on building
Amneal Pharmaceuticals is offering refunds for 340B overcharges on an 18-page-long list of products for purchases between Q3 2019 and Q3 2022.

Generic and specialty drug manufacturer Amneal Pharmaceuticals is offering refunds for 340B overcharges on an 18-page-long list of products for purchases between Q3 2019 and Q3 2022.

The U.S. Health Resources and Services Administration posted New Jersey-based Amneal’s notice to

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Bottom Line, not Altruism, Could be the Main Driver of Lilly’s Insulin Price Cut, Drug Pricing Expert Says

Humalog vial
Lilly's decision to cut the price of its fast-acting insulin Humalog might have been driven by a desire to avoid exposure to Medicaid rebates, drug pricing expert Sean Dickson says.

Drug manufacturer Lilly’s announcement last week that it is slashing the price of Humalog, its most commonly prescribed insulin, may have been less about altruism and more about avoiding exposure to bigger Medicaid rebates, a prominent drug pricing expert says.

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