August 5, 2010 – The full Senate Appropriations Committee has proposed a $3 million raise for the Office of Pharmacy Affairs (OPA) for the fiscal year that begins Oct. 1.
In a report accompanying its 2011 federal health spending bill, the committee also expresses its concern with OPA’s proposal to narrow the definition of “patient” for 340B purposes and asks the Health Resources and Services Administration (HRSA) to coordinate more closely with the Centers for Medicare and Medicaid Services (CMS) on 340B matters.
The committee’s House counterpart still hasn’t passed its own health appropriations bill and Congress might run out of time to pass final legislation before it adjourns for the November elections. In that event, OPA funding probably would remain at this year’s $2.2 million level. That would be a hardship for the office, which early this week began the process of enrolling an estimated 6,000 new sites to the program and also has a full plate of regulations to publish and new initiatives to implement.
The Senate panel’s $5.2 million allocation for OPA matches the Obama administration’s budget request for the office. The Health Resources and Services Administration (HRSA), OPA’s parent agency, would get $7.51 billion, less than the $7.62 billion sought by the administration but an increase over its current $7.50 billion budget.
The committee said it expected OPA to use its additional funding to help resolve ongoing deficiencies including “non-compliance with the 340B pricing requirements and errors and omissions in the office’s covered entity database.” 340B stakeholders have sought improvements in OPA’s covered entity database for years and the health care reform law enacted earlier this year requires OPA make such improvements.
For the third straight year, the committee also weighed in on OPA’s controversial proposed change to the definition of a “patient” eligible to receive discounted drugs. OPA issued proposed guidelines in 2007 that many providers fear would severely limit 340B’s scope, denying many patients discounted drugs for which they are now eligible. The proposal remains in limbo, never withdrawn but never published.
The Senate committee said it “strongly supports a definition of patient that protects the 340B drug program’s integrity while ensuring the nation’s healthcare safety net is not weakened.” Addressing reports that HRSA contractors charged with providing technical assistance to 340B providers have been basing their advice on the proposed patient definition, the committee said it “expects HRSA to provide guidance to 340B-covered entities based upon current law.”
The committee also addressed the lack of coordination between HRSA and the Centers for Medicare and Medicaid Services (CMS), whose policies have a direct affect on 340B discounts. It asked the two to form a working group “to ensure that all phases of the 340B drug discount program are administered without redundancy or contradiction by the two agencies of jurisdiction.”