Senate Appropriators Say 340B Is Not Just an “Individual Discount”

by admin | July 15, 2013 6:53 am

July 15, 2013—The full Senate Appropriations Committee has strongly reaffirmed that the 340B program is “more than simply an individual discount program” in report language accompanying its fiscal 2014 spending bill for labor, health, and education programs.[ms-protect-content id=”2799″]

In the companion report to the spending bill, the panel said “the 340B program was designed to help safety net providers maintain, improve, and expand patient access to healthcare services generally.”

“In establishing the 340B program in 1992, Congress explicitly stated that the 340B program was intended to ‘enable entities to stretch scarce Federal resources as far as possible,’ ” it said. “As [the Office of Pharmacy Affairs] continues to improve and enhance oversight of the 340B program, the Committee urges OPA to implement policies that maximize the healthcare safety net and expand patient access to healthcare. ”

Critics of 340B argue[1] that Congress created the drug discount program for the narrow purpose of helping uninsured indigent patients obtain prescription drugs. They say the program has grown too large and should be limited to improving access to medicines for the poor and those with no insurance.

Hospitals and other health care providers[2] that serve high volumes of poor, uninsured, and underinsured patients argue that 340B was created to save them money on outpatient drugs, enabling them to serve more patients and improve patient services.

The Senate committee passed the bill on July 11. It would provide OPA, the office within the Health Resources and Services Administration (HRSA) that administers the 340B program, with $4.46 million in line-item funding. The bill also would authorize OPA to collect an estimated $6 million more through a 0.1 percent user fee on 340B drug purchases. The Senate’s panel’s 340B spending figures roughly match those in the Obama administration’s budget request[3].

In the passage of its report discussing the proposed 340B user fee, the Senate committee said it “remains strongly committed to OPA’s plans to develop a transparent system to verify the accuracy of the 340B ceiling price.” It said user fee revenues would pay for such a system and “fund the implementation of program integrity provisions” that were recommended by the Health and Human Services Office of Inspector General and included in the Affordable Care Act (ACA).

The committee said it “continues to note that there is currently no way for eligible entities to know if they are paying manufacturers the correct prices for 340B drugs. The ACA requires HRSA to make 340B ceiling prices available to covered entities through a secure web site. Given that the new cost recovery fee is being paid by 340B participating entities, the committee directs HRSA to make this web site the first activity funded by the fee.”

Also in the report, the committee commended HRSA “for delaying the enforcement” of the inventory management requirement laid out in its new group purchasing exclusion guidance until Aug. 7. It said it remains concerned, however, and it urged the agency “to create an understanding” of the term covered outpatient drug “that is more specific to the 340B program.”

“This would allow 340B-participating entities to use other available purchasing methods to obtain access to non-340B drugs at a lower cost,” the committee said.

HRSA’s Feb. 7 clarification of its policy on the statutory prohibition against obtaining covered outpatient drugs through a group purchasing organization (GPO) has forced some hospitals to purchase drugs at wholesale acquisition cost instead of through their lower-priced GPOs, even when the drugs are for individuals who are not eligible for the 340B program.[/ms-protect-content]

Source URL: https://340bemployed.org/senate-appropriators-say-340b-is-not-just-an-individual-discount/

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