February 3, 2014—The Centers for Medicare and Medicaid Services (CMS) is once again delaying enforcement of its new "two-midnight rule" for deciding whether a patient is an inpatient for Medicare billing purposes. [ms-protect-content id="2799"] Under the rule, hospitals can bill Medicare for procedures, tests, and other treatments on an inpatient basis only when the … [Read more...]
OIG Is Working on Three 340B Studies
Reports coming on contract pharmacy, manufacturer overcharges, passing savings to MedicareFebruary 3, 2014—The Department of Health and Human Services Office of Inspector General (OIG) plans to issue three important studies about the 340B program by this fall on contract pharmacy, overcharging by drug manufacturers, and passing savings along to Medicare. [ms-protect-content id="2799"] OIG announced the studies in its annual work plan, released late on Jan. 31. … [Read more...]
340B Ally Rep. Henry Waxman Retiring
Played a key role in program's creation, expansion, and oversightJanuary 30, 2014—Rep. Henry Waxman (D-Calif.), a driving force behind the 340B program's creation and one of its strongest defenders, has decided not to seek reelection in the fall and will retire at the end of this year. [ms-protect-content id="2799"] As chairman of the House Energy and Commerce Subcommittee on Health and the Environment in 1992, Waxman successfully … [Read more...]
340B Recertification Starts Feb. 10 for Most Centers and Grantees
Hospitals and family planning centers will go through process later this yearJanuary 30, 2014—All 340B covered entities other than hospitals and Title X family planning centers will need to recertify their eligibility for the drug discount program during a four-week period that begins Feb. 10, according to the Health Resources and Services Administration (HRSA) Office of Pharmacy Affairs (OPA).[ms-protect-content id="2799"] The Affordable Care Act … [Read more...]
Texas Medicaid Moving Away From Acquisition Cost Billing for 340B Drugs
State would base reimbursement instead on its best estimate of 340B pricesJanuary 29, 2014—Texas Medicaid proposes to stop requiring health care providers to bill it for 340B drugs at actual acquisition cost (AAC) and to begin reimbursing providers instead based on its best estimate of a drug’s 340B price plus a dispensing fee. [ms-protect-content id="2799"] The Texas Health and Human Services Commission (HHSC) outlined the change in a Jan. 3 … [Read more...]
PhRMA, DOJ File Final Briefs in 340B Orphan Drug Case
Decision could come as soon as MarchJanuary 23, 2014—The federal government and drugmakers have made their final arguments in the industry's lawsuit over the government regulation that lets certain rural and cancer hospitals access 340B discounts on orphan drugs when used for non-orphan indications. [ms-protect-content id="2799"] Federal District Judge Rudolph Contreras is expected to rule quickly, perhaps as … [Read more...]
Congress Agrees to More than Double 340B Program Funding
OPA would be expected to implement long-delayed requirementsJanuary 14, 2014—House and Senate negotiators have signed off on a federal spending bill for the fiscal year that runs through September that would more than double the Health Resources and Services Administration (HRSA) Office of Pharmacy Affairs' (OPA) budget, including $6 million for new 340B program integrity efforts. [ms-protect-content id="2799"] Congress could pass the … [Read more...]