July 21, 2009 – The Senate Health, Education, Labor & Pensions Committee (HELP) approved health care reform legislation last week that contains numerous reforms to the 340B Drug Discount Program. The bill would, among other things, extend the 340B discount to the inpatient setting in disproportionate-share hospitals participating in the program, and make free-standing children’s hospitals and certain rural hospitals eligible to join.
The 340B provisions were the target of several amendments that sought to stop efforts to expand the program and, in one case, to eliminate the 340B discount completely for some providers.
An amendment introduced by Senator Mike Enzi (R-Wy.) proposed doing away with the 340B program by 2015 for all providers except those with very high uninsured populations. He also proposed to remove the 340B reform provisions from the legislation. Enzi withdrew those amendments before the committee could consider them.
Another amendment offered by Sen. Orrin Hatch (R-Utah) that would have removed provisions extending 340B to the inpatient setting and to children’s and rural hospitals was modified, leaving the bill’s 340B provisions intact. It did, however, request a non-binding government study on the future of the 340B program. The new Hatch amendment was approved by the committee unanimously.
In addition, an amendment by Sen. Sherrod Brown (D-Ohio) to make free-standing cancer hospitals eligible for the 340B discount was accepted by the committee. Such hospitals are exempt from the Medicare prospective payment system and there are about 10 institutions today that qualify for the designation.
Sen. Enzi opposed the amendment, saying the Senate should not expand participation in the 340B program at the same time that it seeks to provide health insurance coverage to every American.
The HELP Committee is now waiting for the Senate Finance Committee to complete its version of health care reform. Once the Finance Committee approves its bill, the two bills will be merged and considered by the entire U.S. Senate.
340B reform cleared another important legislative hurdle last week, when the U.S. House of Representatives included language to extend the 340B program to the inpatient setting and to new covered entities in H.R. 3200, America’s Health Care Choices Act of 2009.
The legislation was approved by two of the three House committees that have jurisdiction over the health care reform, Ways & Means and Education & Labor. The Energy & Commerce Committee, which has jurisdiction over the 340B program, is scheduled to complete its consideration of the bill this week.