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Leave 340B Alone, CMS Advisory Group Says

The Centers for Medicare & Medicaid Services should not significantly reduce Medicare payments for some prescription drugs.
Or so says one of CMS’s own advisory panels.
The agency’s Advisory Panel on Outpatient Prospective Payment reached this conclusion after listening to testimony from hospital industry stakeholders who told of the savings the federal government’s 340B prescription drug discount program produces and how those savings enable hospitals in low-income areas to help low-income patients who would not otherwise be able to afford their drugs and help improve access to care for low-income patients with very limited health care options.
The panel’s recommendation came just a month after CMS proposed reducing Medicare reimbursement for 340B drugs from its current level, average sales price plus six percent, to average sales price less 22.5 percent..
Critics of the program maintain that it is abused by hospitals, which are not required to reinvest their 340B savings in health care for the poor.  Program supporters maintain that hospitals do use those savings for this very purpose.
Most Pennsylvania safety-net hospitals participate in the 340B program and consider it an essential part of their overall effort to serve the many low-income residents of the communities they serve.
CMS called for the change in the 340B program in a proposed regulation published in July.  Interested parties have until September 11 to comment on the proposal.
Learn more about this issue and the CMS advisory panel’s recommendation in this Fierce Healthcare article.

2017-09-01T06:00:36+00:00September 1st, 2017|Medicare, Pennsylvania safety-net hospitals, Uncategorized|Comments Off on Leave 340B Alone, CMS Advisory Group Says

MedPAC Offers DSH, 340B Recommendations

The Medicare Payment Advisory Commission has recommended that Congress direct changes in the 340B prescription drug discount program and in the manner in which Medicare makes disproportionate share hospital payments (Medicare DSH).
In its annual report to Congress, MedPAC recommended a reduction in 340B prescription drug payments to hospitals. The proposed reduction would cut 340B program spending approximately $300 million.
medpac-dataMedPAC then recommended that those 340B savings be redirected to the Medicare DSH uncompensated care pool.
And it also called for distributing the money in that pool based on better data on the uncompensated care hospitals provide, as reported on hospitals’ Medicare cost report S-10 worksheets, so that the Medicare DSH uncompensated care program would “…better target additional payments to hospitals that provide above average shares of uncompensated care.”
Most Pennsylvania safety-net hospitals participate in both the 340B and Medicaid DSH programs.
To learn more about these and other MedPAC recommendations, see the news release that accompanied the MedPAC report to Congress; a fact sheet on that report; and the report itself.

2016-03-23T06:00:39+00:00March 23rd, 2016|Medicare|Comments Off on MedPAC Offers DSH, 340B Recommendations

340B Program Under the Microscope

Federal officials continue to cast a wary eye on a program that gives discounts on prescription drugs to hospitals that care for large numbers of low-income patients.
The federal 340B Prescription Drug Program requires drug manufacturers to give discounts to eligible providers for the prescriptions they provide patients on an outpatient basis; the hospitals then provide their low-income patients with their prescriptions at a discount or free of charge.  The program has grown a great deal in recent years and now, critics argue that some hospitals that currently receive the discounts should not qualify for them and others are not reinvesting the savings the program generates in care for low-income patients.
Hospitals, meanwhile, note that program savings enable them to fund clinics and otherwise unaffordable programs and services and help them absorb the cost of uncompensated care.
The controversy has drawn congressional interest, and the federal agency that administers the program, the Health Resources and Services Administration, was expected to produce new guidelines governing eligibility and the use of prescription drug discounts.  Those guidelines have been delayed in the wake of a federal court ruling involving orphan drug sales that has called into question the agency’s regulation-issuing authority.
Most Pennsylvania safety-net hospitals participate in the program.
Learn more about the 340B Prescription Drug Program, its growth in recent years, the concerns raised about it amid that growth, and what to expect next in this Kaiser Health News article.

2014-06-25T06:00:32+00:00June 25th, 2014|Uncategorized|Comments Off on 340B Program Under the Microscope
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