700 Hospitals Urge Lawmakers To Protect 340B Drug Discount Program

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More than 700 hospitals and health systems are asking House and Senate leadership to protect the 340B drug discount program in light of recent regulations and legislative proposals the providers say would “undo more than two decades of bipartisan work” on the safety net.

“Americans are right to be upset with the high prices being charged for new and existing drugs, and cutting back the 340B program would make these problems much worse,” the hospitals say in an Oct. 2 letter to Senate Majority Leader Mitch McConnell (R-KY), Senate Minority Leader Charles Schumer (D-NY), House Speaker Paul Ryan (R-WI) and House Minority Leader Nancy Pelosi (D-CA). Maureen Testoni, interim president and CEO of 340B Health, said the hospitals that signed the letter make up the majority of the group’s membership.

In the 2018 hospital outpatient pay rule, CMS cut hospitals’ Medicare pay for 340B drugs by almost 30 percent — which the American Hospital Association, Association of American Medical Colleges and America’s Essential Hospitals have sued over twice — but hospital off-campus facilities that were paid under the Medicare physician fee schedule, due to a site neutrality provision in the Bipartisan Budget Act of 2015, were exempted from the cut. Some stakeholders complained, but CMS did not change the policy last year. The agency has, however, proposed to extend Medicare reimbursement cuts to those off-campus facilities in the 2019 hospital outpatient pay rule.

Hospitals have also raised concerns about the Health Resources and Services Administration repeatedly pushing back the 340B ceiling price and penalties rule, and have sued to force implementation of the final rule.

On the legislative side, the hospitals have raised concerns that a number of bills introduced in both chambers, mostly by Republicans, could limit the program.

Testoni said the letter comes during a year of heightened congressional scrutiny of the 340B program.

AHA recently touted a new voluntary 340B reporting program as an alternative to legislation to help achieve transparency in 340B, but some lawmakers that introduced 340B reform legislation said such an initiative doesn’t remove the need for congressional action.

Testoni noted that 340B Health has endorsed the AHA initiative, but said the letter and the voluntary reporting program are separate. — Michelle M. Stein ([email protected])