Archive for 340b

 

FEDERAL HEALTH POLICY UPDATE FOR November 3

The following is the latest health policy news from the federal government for the week of October 31 to November 3.  Some of the language used below is taken directly from government documents.

Medicare Payment Regulations

In the past week CMS has published four regulations presenting how it will pay providers in the coming year.

Federal Health Policy Update for October 27

The following is the latest health policy news from the federal government for the week of October  21 to October 27.  Some of the language used below is taken directly from government documents.

340B

  • Responding to a federal court ruling that the federal government has shortchanged hospitals in its payments for 340B-covered prescription drugs, CMS has announced how it will compensate hospitals for its underpayments – at least for the 2023 fiscal year.  According to CMS, it “…will apply the default rate (generally ASP plus 6%) to 340B-acquired drugs for the rest of the year.  CMS also will reprocess claims our contractors paid on or after September 28, 2022, using the default rate (generally ASP plus 6%).”  Learn more here.

Centers for Medicare & Medicaid Services

  • CMS has published a guide for states on how they can maximize the use of automation when they review current Medicaid participants’ eligibility when the COVID-19 public health emergency ends, doing so by using reliable information that is already available to state Medicaid agencies and without seeking information directly from the individuals whose Medicaid eligibility is under review.  Learn more from the CMS document “Ex Parte Renewal:  Strategies to Maximize Automation,

Federal Health Policy Update for October 6

The following is the latest health policy news from the federal government for the week of September 26 to October 6.  Some of the language used below is taken directly from government documents.

340B

  • HHS must immediately end its significant cut in reimbursement for 340B-covered prescription drugs provided on an outpatient basis to eligible patients, a federal court has ruled, writing that “The prospective portion of the 2022 reimbursement rate shall be vacated because it is defective and because vacating this portion of the 2022 OPPS Rule will not cause substantial disruption” and that “HHS should not be allowed to continue its unlawful 340B reimbursements for the remainder of the year just because it promises to fix the problem later.”  Learn more from this federal district court decision.
  • In response to this ruling, HHS shared its plan for responding to the court order by restoring a payment rate of average sales price plus six percent for 340B-covered drugs.  In a brief to the court it explained that “…the process of adjusting the 2022 OPPS payment rates for 340B hospitals would take approximately two weeks” because it “requires revisions to four different electronic data files and then testing by multiple

FEDERAL HEALTH POLICY UPDATE FOR THE WEEK OF SEPTEMBER 12-16

The following is the latest health policy news from the federal government for the week of September 12-16.  Some of the language used below is taken directly from government documents.

No Surprises Act

  • The Department of Health and Human Services, the federal Office of Personnel Management, the Internal Revenue Service, the Department of the Treasury, the Department of Labor, and the Employee Benefits Security Administration have issued a request for information (RFI) seeking stakeholder comment on how to implement the No Surprises Act’s requirement that health care providers and payers give explanations of benefits and good-faith estimates of costs for services and items that are scheduled at least three days in advance to individuals who have health insurance.  Previous regulations have focused on the delivery of this information to uninsured and self-pay patients and those obtaining services from out-of-network providers, but providers and payers asked regulators to delay implementation of the law’s requirements for the provision of such information to insured patients so they could address the technical infrastructure needed to transfer data effectively and in a timely manner between and among providers and payers.  Learn more this Federal Register notice.  Comments in response to the RFI are due

Federal Health Policy Update for the Week of September 5-12

The following is the latest health policy news from the federal government for the week of September 5-12.  Some of the language used below is taken directly from government documents.

The White House

  • The White House has published a fact sheet on the administration’s plan to get Americans an updated COVID-19 shot and to manage COVID-19 this fall.  The major components of the plan are providing access to free, updated vaccines; ensuring easy access to testing and treatment; encouraging safe practices; and preparing for potential surges and new variants.  Find that fact sheet here.
  • The White House’s COVID-19 response team and other public officials have briefed the press on the federal government’s latest efforts in its response to the COVID-19 public health emergency.  Find a transcript of that briefing here.

Centers for Medicare & Medicaid Services

  • CMS has issued a request for information “…seeking public input on accessing healthcare and related challenges, understanding provider experiences, advancing health equity, and assessing the impact of waivers and flexibilities provided in response to the COVID-19 Public Health Emergency.”  The request for information also seeks feedback to inform CMS’s assessment of the impact of waivers and flexibilities provided in response to the