October 20, 2009 -Four drug companies — Mylan Pharmaceuticals, UDL Laboratories, AstraZeneca Pharmaceuticals and Ortho McNeil — have settled allegations that they underpaid rebates to the Medicaid program by falsely designating so-called "innovator" drugs as "non-innovator" drugs. And as they have in several high-profile settlements as of late, 340B-covered entities are … [Read more...]
OIG’s 2010 Work Plan Probes 340B Reimbursements
The U.S. Health and Human Services' investigative arm is examining how safety-net providers get paid by Medicaid and Medicare for outpatient drugs. The OIG also wants to know if drug makers report prices in a timely manner.October 19, 2009 - The U.S. Department of Health and Human Services' Office of Inspector General (OIG) recently released its Fiscal Year 2010 Work Plan. Several of the studies and inquiries into Health and Human Services (HHS) programs and operations focus directly on the 340B program, including two that examine reimbursement levels for 340B providers. This has some in the … [Read more...]
Coordinated Care – Another Way to Pay for Health Reform?
How about saving Medicare and Medicaid $133 billion-plus a year, and private plans almost $107 billion? Coordinated care can do magic, consultant says.October 19, 2009 - The numbers, if true, are mind-boggling. If physicians, drug manufacturers, private insurers and public plans worked together to coordinate and ensure continuity of care for patients, Medicare and Medicaid alone would save an estimated $133.5 billion annually, says a new study by Southeastern Consultants. Private plans would save an additional $106.6 … [Read more...]
Children’s Hospital of Michigan is First to Enroll in 340B
The hospital was first out of the gate in early 2006, and first to join the drug discount program now that federal guidelines are finally in place. The Detroit institution says its savings will be "significant."Children's Hospital of Michigan October 19, 2009 - Children's Hospital of Michigan is the first children's hospital to be officially enrolled in the 340B drug discount program. It took the 225-bed hospital more than three years and a re-submittal of its application, but now that it's all said and done, hospital employees who pushed hard for the designation are both … [Read more...]
NDC Reporting Not Mandated for Outpatient Drugs, CMS Says
Safety-net hospitals get federal relief from a controversial reporting policy that was costing some millions of dollars to implement. It's now up to states whether or not to require the NDCs.October 9, 2009 - After more than a year of legal wrangling over a requirement that hospitals report national drug codes (NDCs) for physician-administered outpatient drugs, the Centers for Medicare & Medicaid Services (CMS) has agreed to modify its controversial 2007 policy. It will now be up to individual states to decide whether to continue to require hospitals to … [Read more...]
Ohio Carve-Out Ban Failed; Other States Press On
Financially strapped states continue to seek ways to trim Medicaid reimbursements for 340B providers. Who's next on the carve-out no-no list?October 7, 2009 - Some safety-net providers in Ohio drew a sigh of relief in July when learning that they could continue to exclude Medicaid drugs from the 340B program, a billing technique that protects a coveted revenue source for such providers. Language in the Ohio fiscal 2010 state budget that would have required 340B-covered health care facilities to buy their Medicaid … [Read more...]
PhRMA Escapes a Bullet
A proposal to expand the Medicaid rebate program to dual eligibles hit political reality this week. Lawmakers feared the measure would drive PhRMA away from health care reform.September 25, 2009 - It's all about lowering costs and providing universal and better health care for Americans. So why is it that a proposal to shift so-called dual eligibles from Medicare to Medicaid – a $86 billion saving to the government over 10 years – was voted down by Democrats who had long pushed for such a policy change? Sen. Bill Nelson (D-Fla.) introduced an … [Read more...]