340B Drug Pricing Program

HHS finalizes 340B Administrative Dispute Resolution process

April 22, 2024 - A new rule from HHS finalizes a revised Administrative Dispute Resolution (ADR) process under the 340B Drug Pricing Program (340B), which will allow covered entities to address disputes with pharmaceutical companies. Hospitals and other covered entities have been at odds with the pharmaceutical companies that provide discounted drugs under...

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How Many Medicare Part D Claims Are Subject to 340B Discounts?

by Victoria Bailey

The share of Medicare Part D claims eligible for discounts in the 340B drug pricing program increased from 1.7 percent to 9.6 percent between 2013 and 2020, a study published in JAMA Health Forum...

CMS Will Issue OPPS Providers Lump-Sum Payments to Remedy 340B Losses

by Victoria Bailey

Hospital Outpatient Prospective Payment System (OPPS) providers participating in the 340B drug pricing program will receive a one-time lump-sum payment to offset losses between calendar years (CYs)...

Healthcare Orgs Address Price Transparency, 340B Policies in OPPS

by Victoria Bailey

Hospital and specialty groups are urging CMS to amend aspects of the CY 2024 Outpatient Prospective Payment System (OPPS) proposed rule, including 340B Drug Pricing Program policies and price...

CMS to Resolve 340B Payment Mixup With $9B Lump-Sum Fix

by Jacqueline LaPointe

CMS has proposed to pay $9 billion to hospitals impacted by payment cuts to the 340B Drug Pricing Program between 2018 and 2022. The proposal is CMS’ remedy to cutting 340B payments from the...

Lawmakers Seeking Stakeholder Input to Improve 340B Drug Pricing Program

by Victoria Bailey

A group of bipartisan lawmakers is seeking feedback from stakeholders on how Congress can improve the 340B Drug Pricing Program and ensure transparency and stability within the program. US Sens. John...

340B Program Enrollment Led to More Oncology Services at Rural Hospitals

by Victoria Bailey

Rural hospitals that participated in the 340B Drug Pricing Program were more likely to introduce oncology services than facilities that did not enroll in the program, a study published in Health...

340B Drug Pricing Program Eligibility Tied to Lower Biosimilar Use

by Victoria Bailey

Participation in the 340B drug pricing program was associated with reduced biosimilar use and more biologic administrations, a study published in Health Affairs found. The 340B program allows eligible...

Judge Wants HHS to Remedy 340B Underpayments to Hospitals

by Jacqueline LaPointe

A federal court has decided to let HHS determine how to repay hospitals for years of 340B underpayments. The decision issued Tuesday by the US District Court for the District of Columbia comes as a...

HHS Proposes Changes to 340B Administrative Dispute Resolution

by Victoria Bailey

HHS has proposed revisions to the 2020 final rule on the 340B Administrative Dispute Resolution (ADR) process to modify policy and operational challenges. The ADR process in the 340B Drug Pricing...

CMS Will Apply Higher 340B Hospital Reimbursement Rate After Court Ruling

by Jacqueline LaPointe

Following a court order, CMS is revising its methodology for paying 340B hospitals for outpatient drugs and reprocessing claims paid on or before the Sept. 28th ruling. CMS will reimburse hospitals...

AHA Asks Federal Court to Immediately Stop 340B Payment Cuts

by Jacqueline LaPointe

The American Hospital Association (AHA) has asked the US District Court for the District of Columbia to order HHS to immediately halt underpayments to hospitals participating in the 340B Drug Pricing...

340B Hospitals Treated High Shares of Underserved Populations

by Victoria Bailey

Compared to non-340B hospitals, 340B hospitals provided care for a higher share of historically underserved populations, including dual eligible beneficiaries, people with disabilities, and Black...

340B DSH Hospitals Provided $41B in Uncompensated Care in 2020

by Victoria Bailey

Despite experiencing negative operating margins, 340B disproportionate share (DSH) hospitals provided 67 percent of all uncompensated care in 2020, according to a report from 340B Health and...

CMS Proposes 2.7% Increase in CY23 OPPS, ASC Reimbursement Rates

by Victoria Bailey

CMS has released its Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System proposed rule for calendar year (CY) 2023, which includes a 2.7 percent...

AHA Calls for Timely Repayment to 340B Hospitals After Unlawful Cuts

by Victoria Bailey

The American Hospital Association (AHA) has asked HHS to ensure 340B hospitals receive timely repayment following the Supreme Court’s decision that the department’s 340B Medicare...

Hospitals Win Supreme Court Case on 340B Reimbursement Cuts

by Victoria Bailey

The US Supreme Court has sided with the American Hospital Association (AHA) and other hospital groups and determined that the 340B Medicare reimbursement cuts for hospitals were unlawful. In the 2018...

Are PBMs Unjustly Profiting from 340B Drug Pricing Program?

by Victoria Bailey

The Community Oncology Alliance (COA) has raised concerns that the high volume of contract pharmacies participating in the 340B drug pricing program allows pharmacy benefit managers (PBMs) to profit...

AHA Calls for Oversight of Pharmacy Benefit Manager Practices

by Victoria Bailey

The American Hospital Association (AHA) has urged the Federal Trade Commission (FTC) to increase its surveillance of commercial health plan and pharmacy benefit manager (PBM) practices that steer...

Hospital Groups Urge Courts to Enforce 340B Drug Pricing Requirement

by Victoria Bailey

Five hospital organizations, including the American Hospital Association (AHA) and 340B Health, have urged two US Courts of Appeals to uphold the 340B drug pricing requirement for pharmaceutical...

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