CHA Issues Summary of Final Rule on Medicaid Drug Rebate Program, Value-Based Purchasing Arrangements
CHA has issued a detailed summary, prepared by Health Policy Alternatives, Inc., of the final rule issued by the Centers for Medicare & Medicaid Services that makes changes to the Medicaid Drug Rebate Program, drug utilization review, and third-party liability regulations, and revises requirements for value-based purchasing (VBP) agreements between states and manufacturers for drugs covered by Medicaid.
HHS Issues Guidance Requiring Manufacturers to Provide 340B Discount at Contract Pharmacies
On Dec. 30, the U.S. Department of Health and Human Services general counsel issued an advisory opinion requiring pharmaceutical manufacturers to sell covered entities 340B drugs at or below the ceiling price when those drugs are distributed through a contract pharmacy.
DHCS Seeks Federal Approval for No-Cost COVID-19 Vaccines for Medi-Cal Beneficiaries
With the recent Food and Drug Administration approval of COVID-19 vaccines, the Department of Health Care Services (DHCS) is seeking federal approval to help support delivery of the vaccine to all Medi-Cal beneficiaries.
HRSA Releases 340B Drug Pricing Program Administrative Dispute Resolution Final Rule
On Dec 10, the Health Resources and Services Administration (HRSA) released a final rule establishing a process to resolve disputes between 340B-covered entities and drug manufacturers.
CHA Releases Summaries of New Drug Pricing Payment Model and Part D Safe Harbor Final Rules
CHA has issued detailed summaries, prepared by Health Policy Alternatives, of two drug pricing final rules recently published by the Department of Health & Human Services (HHS).
DHCS Delays Implementation of Medi-Cal Rx Until April 1
Given the ongoing challenges associated with the COVID-19 public health emergency, the Department of Health Care Services (DHCS) has decided to delay the full implementation of Medi-Cal Rx until April 1, 2021.
DHCS Posts Medi-Cal Rx Prescriber and Pharmacy Training Registration
In advance of the transition of pharmacy services to Medi-Cal Rx starting on Jan. 1, 2021, the Department of Health Care Services recently launched a training registration application on the Medi-Cal Rx portal for Medi-Cal prescribers and pharmacies.
Urge Representatives to Sign ‘Dear Colleague’ Letter on 340B Drugs
Hospitals participating in the 340B program are being urged to ask their representatives to sign an important Dear Colleague letter to the Department of Health and Human Services (HHS), in response to recent actions taken by several drug companies to limit the distribution of certain 340B drugs to hospitals and health systems.
DHCS Issues Self-Audit Demand of 340B Providers
Last month, the Department of Health Care Services (DHCS) sent a letter to every 340B provider/covered entity (hospitals, clinics, and contracted pharmacies) demanding they conduct a self-audit of paid fee-for-service (FFS) claims data from Dec. 1, 2016, through Dec. 31, 2019. The stated purpose of the self-audit is to ensure the provider billed appropriately in the FFS delivery system at the actual acquisition cost and to disclose any overpayment.
Appeals Court Upholds Payment Cut for 340B Hospitals
On Friday, the U.S. Court of Appeals for the District of Columbia Circuit overturned a 2018 district court decision that found the Department of Health and Human Services (HHS) exceeded its statutory authority when it reduced 2018 and 2019 Medicare payment rates for many hospitals in the 340B Drug Pricing Program by nearly 30%.