NACHC image of core principles for 340B reform
“Health centers and their patients cannot afford more [contract pharmacy] restrictions or PBM discriminatory contracting," NACHC says in document urging Congress "to amend the 340B statute to protect access for the true safety-net providers.”

NACHC Hill Day Document Calls for 340B Reform and Offers Guiding Principles, Key Hill Staffer Joins Organization

The National Association of Community Health Centers says in a new advocacy document “it’s time to reform the 340B program to recognize the complexities of today’s healthcare system and ensure that true safety-net providers continue to have access to critical resources for America’s most vulnerable and underserved patients.”

It calls for protecting the 340B program’s “true intent” of helping covered entities provide affordable health care services and medications to low-income and vulnerable patients, removing entities that do not fulfill those obligations, adding a contract pharmacy policy to the 340B statute, establishing transparency and accountability requirements, and prohibiting discriminatory practices that divert 340B savings to for-profit companies.

NACHC is holding its annual Policy & Issues Forum in Washington, D.C., this week, and its annual congressional lobbying day is Thursday. The 340B two-pager is among several on various topics that NACHC created for its members to use during their Capitol Hill meetings.

National hospital group 340B Health told its members last week that NACHC and Pharmaceutical Research and Manufacturers of America were jointly developing 340B policy proposals for Congress to consider. NACHC and PhRMA both had no comment about the report.

“Over the last three years, health centers have lost mission-critical 340B savings while the Health Center Program hit a historic record of 30 million patients,” the NACHC 340B advocacy document says.

“The impact of contract pharmacy restrictions and ongoing abuse by Pharmacy Benefit Managers (PBMs) has forced health centers to develop new core principles for reforming the 340B Program,” it says. “Health centers and their patients cannot afford more restrictions or PBM discriminatory contracting. We urge Congress to amend the 340B statute to protect access for the true safety-net providers.”

The document outlines five principles to move 340B “towards more stability, accountability, and transparency”:

  1. “Preserving the 340B Program to protect its true intent to help support safety net providers serving low-income and vulnerable patients. The 340B Program needs stability so safety-net providers can effectively care for patients that otherwise would not have access to affordable healthcare services and the medications on which they depend.”
  2. “Reforming 340B eligibility to remove covered entities that do not uphold their obligation to provide affordable health care services and medications to significant amounts of safety-net patients and underserved communities.”
  3. “Incorporating a contract pharmacy policy into the 340B statute to create consistency and safeguards for compliance and accountability. For instance, outlining statutory requirements for contract pharmacies to protect against abusive practices and ensure vulnerable patients benefit from the program.”
  4. “Establishing transparency and accountability requirements to increase federal oversight by mandating covered entities to report basic 340B information to ensure the program’s integrity.”
  5. “Create statutory requirements for Health Insurers and Pharmacy Benefit Managers to prohibit discriminatory practices that divert 340B savings to for-profit companies and away from safety-net providers and vulnerable patients.”

The document does not mention the drug industry. Webinar slides among the lobby day materials list the 340B program among health centers’ top three legislative priorities this year, together with health center funding and workforce development. The bullet point for 340B says: “Building consensus with likely allies and unlikely partners around a new approach that stabilizes the program and protects access for health centers.”

New Federal Policy Director with Significant 340B Experience

In a related development, NACHC confirmed yesterday that it has hired Nicholas Widmyer to be its federal policy director.

Widmyer for the past three years was senior policy adviser to U.S. Rep Abigail Spanberger (D-Va.). Spanberger is one of the most vocal 340B champions on Capitol Hill and is considered a strong ally of the 340B provider community.

Widmyer played important behind-the-scenes roles in several of Spanberger’s 340B initiatives, including getting co-sponsors for the Congresswoman’s bipartisan PROTECT 340B Act and signers for bipartisan House letters supporting 340B providers and calling on the government to penalize drug manufacturers for placing restrictions in the contract pharmacy setting. In February 2022, President Biden thanked Spanberger for her work in protecting the 340B program during a health care policy event in her district.