Healthcare Revenue Cycle Management, ICD-10, Claims Reimbursement, Medicare, Medicaid

Prescription Drug Rates

Providers Seek Prescription Price Transparency, Patient Cost Data

February 13, 2019 - Providers want to boost prescription price transparency to lower costs and improve care quality, a new survey of over 500 healthcare professionals uncovered. The Engine Group and Surescripts survey showed that 78 percent of professionals think it is very important to have access to information on patient out-of-pocket costs. Another 69 percent also believed access to information on...


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Major Health Systems Create New Company to Tackle Drug Shortages

by Jacqueline LaPointe

Drug shortages are preventing hospitals from providing even the most basic care to patients. In a recent study by the National Opinion Research Center (NORC) at the University of Chicago, approximately 80 percent of hospitals found it...

Hospital Prescription Drug Spending Increased 18.5% Per Admission

by Jacqueline LaPointe

Average total hospital prescription drug spending per admission rose by 18.5 percent between the 2015 and 2018 fiscal years, according to a new study conducted by NORC at the University of Chicago. Hospitals spent an average of $555.40...

Prescription Drug Spending Higher at 340B Hospitals, Study Finds

by Jacqueline LaPointe

Per-patient prescription drug spending increased by 32.4 percent at hospitals that recently enrolled in the 340B Drug Pricing Program, revealed a new Berkeley Research Group (BRG) study funded by the Pharmaceutical Research and...

Specialists Fear IPI Drug Pricing Model Could Harm Patient Access

by Jacqueline LaPointe

A healthcare industry group representing more than 7,700 rheumatologists and rheumatology health professionals recently warned the Trump Administration that its proposed International Pricing Index (IPI) drug pricing model for Medicare...

HHS Overstepped Authority with 340B Reimbursement Cuts, Judge Rules

by Jacqueline LaPointe

A federal judge in Washington DC recently struck down a nearly 30 percent reduction in 340B reimbursement cuts. US District Judge Rudolph Contreras ruled that HHS Secretary Alex Azar exceeded his statutory authority by issuing a policy...

HHS to Implement 340B Drug Price Ceiling, Penalties in Jan 2019

by Jacqueline LaPointe

After several delays, HHS will implement drug price ceilings and civil monetary penalties for manufacturers under the 340B Drug Pricing Program in 2019, according to a final rule from the HHS agency, Health Resources and Services...

HRSA Proposes Earlier Start Date for 340B Price Transparency Rule

by Jacqueline LaPointe

HHS plans to move forward the implementation date of a long-delayed 340B price transparency rule that will stop drug manufacturers from overcharging hospitals for drugs purchased under the drug discount program. In a recent notice of...

Would the IPI Model Reduce Medicare Reimbursement for Providers?

by Jacqueline LaPointe

Physicians and hospitals would not see Medicare reimbursement drop under the proposed International Pricing Index (IPI) model, the former Senior Advisor to the Secretary for Drug Pricing Reform recently assured providers. “The model...

Potential Medicare Reimbursement Demo to Lower Part B Drug Prices

by Jacqueline LaPointe

In an effort to control prescription drug prices, HHS is proposing a mandatory demonstration that would test a new Medicare reimbursement model for certain physician-administered drugs payable under Part B. The proposed International...

CMS to Extend Healthcare Price Transparency to Prescription Drugs

by Jacqueline LaPointe

CMS is attempting to extend healthcare price transparency to prescription drugs. According to a recently proposed rule, drug manufacturers may have to start including the list price for the medications they advertise on television. As...

Hospital Markups Drive Prescription Drug Spending, PhRMA Says

by Jacqueline LaPointe

Prescription drug spending is rising because approximately 83 percent of hospitals charge patients and payers more than double the acquisition cost for medications, according to a recent analysis by the Moran Company for the Pharmaceutical...

Hospitals Create Drug Company to Combat Drug Shortages, Prices

by Jacqueline LaPointe

Seven health systems are stepping up to the plate to tackle two of the healthcare industry’s most pressing challenges: drug shortages and rising prescription drug rates. Catholic Health Initiatives, HCA Healthcare, Intermountain...

Prescription Drug Rate Growth to Slow in 2019, Increasing 4.92%

by Jacqueline LaPointe

Hospitals and health systems should anticipate prescription drug rates to increase by 4.92 percent in 2019, researchers from the healthcare improvement company Vizient recently estimated. Prescription drug rates for hospitals and health...

340B Hospitals Provided Similar Charity, More Uncompensated Care

by Jacqueline LaPointe

The debate over whether 340B hospitals truly use discounted prescription drug rates to improve care for vulnerable, low-income patients goes on with a new Government Accountability Office (GAO) report. GAO found that the median amount of...

Target Prices to Control Prescription Drug Spending, AHA Advises

by Jacqueline LaPointe

With prices, not utilization, driving prescription drug spending at hospitals and health systems, the American Hospital Association (AHA) recently called on policymakers to focus on controlling costs via average sales price (ASP)...

Court Rejects AHA’s Attempt to Block 340B Hospital Payment Cuts

by Jacqueline LaPointe

A federal appellate court recently tossed the American Hospital Association’s (AHA) lawsuit against HHS, which attempted to block $1.6 billion in 340B hospital payment cuts. Three judges on the US Court of Appeals for the District...

Hospitals to See More 340B Drug Pricing Program Oversight, Azar Says

by Jacqueline LaPointe

According to HHS Secretary Alex Azar, hospitals should expect greater transparency and oversight of the 340B Drug Pricing Program to track how the program’s benefits are used to improve care for low-income and vulnerable...

How Part B Drug Changes Could Impact Provider Reimbursement

by Jacqueline LaPointe

Healthcare industry experts are warning the Trump Administration that its proposal to transfer some drugs covered by Medicare Part B to Part D would have a negative impact on provider reimbursement and care quality. In the Trump...

Oncologist Org Fights Medicare Reimbursement Cut to Cancer Drugs

by Jacqueline LaPointe

A group representing over 5,000 independent, community-based oncologists is suing HHS over the implementation of a two percent sequester cut to Medicare reimbursement for Part B cancer drugs. The Community Oncology Alliance (COA) is...

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