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

Prescription Drug Rates

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

August 13, 2018 - 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 systems are growing at a slower rate compared to the previous year, the purchasing data from hospitals and non-acute facilities in the Vizient Pharmacy...


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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...

Shifting Vaccinations to the Pharmacy Lowers Healthcare Costs

by Jacqueline LaPointe

Pharmacies can administer a wide range of vaccines to patients at significantly lower healthcare costs than physician practices and other medical settings, a new report from the Pacific Research Institute found. The literature review...

Pres Trump Eyes 340B Drug Reforms to Lower Prescription Drug Costs

by Jacqueline LaPointe

The 340B Drug Pricing Program could face some changes under the Trump Administration’s latest plan to reduce prescription drug costs. The United States had the highest per-capita prescription drug spending in 2015, the President...

HRSA Proposes Fifth Delay of 340B Drug Pricing, Penalty Rule

by Jacqueline LaPointe

The Health Resources and Service Administration (HRSA) recently proposed a one-year delay of a final rule that would implement 340B drug pricing rules and civil monetary penalties for drug manufacturers that intentionally overcharge...

CMS Targets Value-Based Purchasing, Drug Costs to Reduce Spending

by Jacqueline LaPointe

Healthcare spending is growing at an unstainable rate, and CMS aims to curb spending through initiatives that promote value-based purchasing, reduce administrative burdens, and lower prescription drug costs, CMS Administrator Seema Verma...

Oncologists Charge 9 to 51% More for Physician-Administered Drugs

by Jacqueline LaPointe

Median charges for physician-administered drugs covered under Medicare Part B were 9 to 51 percent higher at the oncologist than other specialty offices, researchers from Memorial Sloan Kettering Cancer Center and Johns Hopkins University...

340B Hospitals Delivered $26B in Unreimbursed, Uncompensated Care

by Jacqueline LaPointe

Unreimbursed and uncompensated care costs were 27.4 percent higher at Disproportionate Share Hospitals (DSH) enrolled in the 340B Drug Pricing Program in 2015 compared to non-340B acute care hospitals, according to a new analysis from...

AHA, Hospital Groups Renew Call to End 340B Drug Payment Cuts

by Jacqueline LaPointe

After a federal judge recently ruled that CMS can enforce cuts to 340B drug payments, the American Hospital Association (AHA) and 35 state and regional hospital associations resumed their efforts to end $1.6 billion in reimbursement...

Prescription Drug Rate Growth Slows, But Prices Still Rising 7.35%

by Jacqueline LaPointe

Providers should anticipate a 7.35 percent increase in prescription drug rates between July 2018 and June 2019, researchers from Vizient projected in a new study. Based on hospital and non-acute facility purchasing data from the...

85% of Hospitals to See Part B Increase Despite 340B Payment Cuts

by Jacqueline LaPointe

EDITOR'S NOTE: This article has been updated with a statement from the American Hospital Association. Approximately 85 percent of hospitals will receive a net increase in their total Medicare Part B reimbursements despite recent...

Health Systems Form Drug Company to Combat Rising Costs, Shortages

by Jacqueline LaPointe

Intermountain Healthcare, Ascension, SSM Health, and Trinity Health recently announced that they will create a non-profit generic drug company to reduce prescription costs and alleviate critical drug shortages. With consulting services...

Prescription Drug Rates Continue to Challenge Cancer Centers

by Jacqueline LaPointe

Prescription drug rates and the costs of new treatment modalities continued to challenge cancer centers, according to the most recent Trending Now in Cancer Care survey from the Association of Community Cancer Centers (ACCC). For the...

Judge Denies Hospital Org Attempt to Block 340B Drug Payment Cut

by Jacqueline LaPointe

A federal judge recently ruled that CMS can start to reduce 340B drug payments to hospitals by $1.6 billion starting on Jan. 1, 2018, striking a blow to several industry groups that urged the court to delay enforcement of the new rule. US...

Orgs Argue MIPS Adjustments for Drug Payments Harm Patient Access

by Jacqueline LaPointe

Applying Merit-Based Incentive Payment System (MIPS) adjustments to Medicare Part B drug payments will restrict patient access to critical treatments, 11 medical societies recently told congressional leaders. The medical societies,...

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