Pharmacy

Parent Issue

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. 

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%.