Category: Regulatory

Providers Worried About Humana’s 340B Claims ID and Data-Reporting Conditions

In Other Industry, RegulatoryMarch 9, 202111 Views

Health insurance company Humana has begun sending pharmacy provider agreements for 2022 to 340B-participating pharmacies, with claims-identification and data-reporting conditions that some 340B providers say are unsettling. They say the agreements are to be signed and returned within 30 days …

N.Y. and Calif. 340B Pharmacies Get Reprieve From Medicaid Cuts

In Regulatory, StateMarch 2, 20211 Views

Tom Mirga

New York State and California’s nationally watched efforts to transfer their pharmacy programs for low-income individuals from Medicaid managed care to Medicaid fee for service (FFS)—both scheduled to take effect on April 1—have been temporarily placed on hold.

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Express Scripts’ New 340B Rules Will Have Big Impact on Contract Pharmacy and Drug Reimbursement, Providers and Consultants Say

In Federal, Other Industry, RegulatoryFebruary 26, 202130 Views

Tom Mirga

340B covered entities say they are deeply concerned about pharmacy benefit manager Express Scripts’ (ESI) requirements, effective Monday, governing what pharmacies in the PBM’s network must do when they identify that a previously submitted claim is 340B-eligible. Last night, ESI …

Becerra Reconfirms Strong Support for 340B During Finance Committee Hearing

In Federal, RegulatoryFebruary 25, 20219 Views

Tom Mirga

Xavier Becerra, President Biden’s pick to be the next U.S. Health and Human Services (HHS) Secretary survived his U.S. Senate Finance Committee confirmation hearing yesterday, with a GOP foe of his nomination grudgingly predicting the panel would vote to confirm …

Express Scripts’ New 340B Claims ID Requirement Has Covered Entities Worried

In Federal, Other Industry, RegulatoryFebruary 25, 202110 Views

Tom Mirga

Pharmacy benefit manager Express Scripts late yesterday began notifying 340B covered entities by email that, effective March 1, it “will require a new identification method for submitting and identifying 340B eligible claims.”

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HHS-Designate Becerra May Face 340B Questions Today During First Nomination Hearing

In Federal, Legislative, RegulatoryFebruary 23, 20213 Views

Tom Mirga

The U.S. Senate Health, Education, Labor, and Pensions (HELP) Committee this morning is holding the first of two Senate committee hearings this week on President Biden’s nomination of California Attorney General Xavier Becerra to serve as U.S. Health and Human …

Biden Staffs Up with 340B Policy Experts in Key Positions

In Federal, RegulatoryFebruary 23, 20215 Views

Tom Mirga

President Biden is bringing a number of 340B policy experts on board to his team. Yesterday, he formally nominated Andrea Palm, most recently Wisconsin’s health secretary-designate, to be U.S. Deputy Secretary of Health and Human Services (HHS).

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HRSA Allows 340B Enrollment Flexibility in Storm-Battered Texas

In Federal, RegulatoryFebruary 23, 20210 Views

Tom Mirga

The U.S. Health Resources and Services Administration (HRSA), in light of the declared public health emergency in Texas, is letting eligible health care providers there enroll immediately in the 340B drug pricing program instead of waiting for the next normal …

AEH Asks Biden to Prioritize Three 340B-Related Issues

In Federal, RegulatoryFebruary 23, 20210 Views

Tom Mirga

The Biden administration should reverse “harmful Trump administration policies” that “undermined the 340B program and contravened Congress’ intent,” the group America’s Essential Hospitals advised President Biden in a letter earlier this month.

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Senate Hearings Next Week on Becerra’s Nomination to Head HHS

In Federal, Legislative, RegulatoryFebruary 18, 20211 Views

Tom Mirga

Two U.S. Senate committees have scheduled hearings next week on President Biden’s nomination of California Attorney General Xavier Becerra to be the next U.S. Health and Human Services (HHS) Secretary.

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