The 340B Program: Mandatory Reporting, Alternative Eligibility Criteria Should Be Top Priorities For Congress

Policymakers have renewed their focus on how the 340B drug discount program functions among “safety net” hospitals, particularly Disproportionate Share  Hospitals (DSH), which qualify for the 340B program because they provide a sufficient amount of inpatient care to Medicaid and low-income Medicare beneficiaries. In June, a leaked executive order from the Trump administration suggested that the program would start to tie the volume of discounted drugs to indigent patient volume. In July, the Centers for Medicare and Medicaid Services (CMS) proposed cuts to physician reimbursements for outpatient drugs covered under Medicare’s medical benefit (Part B) for 340B DSH hospitals. Tomorrow, October 11th, the House of Representatives’ Oversight and Investigations Subcommittee will hold a hearing titled, “Examining How Covered Entities Utilize the 340B Drug Pricing Program.” Why choose this focus for the October hearing? 340B is a drug discount program that provides qualified hospitals with a 20 percent to 50 percent discount on the average manufacturer price of outpatient prescription drugs, and the opportunity to generate revenue from sales of 340B drugs to insured patients in order to fund safety-net care. While the program provides a vital source of revenue for some participants, there is increasing concern that DSH hospitals and their affiliated clinics and contract pharmacies are abusing the program by pursuing profits rather than ensuring patient access to ...
Source: Health Affairs Blog - Category: Health Management Authors: Tags: Costs and Spending Drugs and Medical Innovation Hospitals Medicaid and CHIP Medicare 340B 340B program disproportionate share hospitals DSH Source Type: blogs