September 14, 2010—The Drug Discount Monitor is now producing an enhanced print edition four times a year. It's replaced our old monthly newsletter and gives you a compilation of our best recent online articles. Please contact Tom Mirga attom.mirga@340binformed.associationbreeze.com or 202-552-5853 to let us know if you want to receive the quarterly print edition by mail for … [Read more...]
Small Provision in Health Care Reform Law Could Have a Big Effect on Drug Settlements
Entire companies, not just business units, would face exclusion from Medicaid and 340B.September 14, 2010—A small provision in the new federal health care reform law could have a big effect on federal government settlements with drug companies accused of overcharging state Medicaid programs and 340B providers. Before the new law, companies being investigated or sued by the government for alleged pricing violations could have a subsidiary plead guilty to the … [Read more...]
New Health Insurance Exchanges Could Expand 340B’s Reach
Private insurers will have to contract with 340B providers in order to join the new markets.September 14, 2010—The federal health care reform provision requiring states to create health insurance exchanges for low-income Americans and small businesses could broaden the reach of the 340B drug discount program significantly. A key element of the Affordable Care Act (ACA), the exchanges will be regulated markets for the purchase of affordable private health insurance. … [Read more...]
CMS Proposes Hike in Medicare Part B Drug Payments, Lower Inpatient Reimbursement
Agency will pay all hospitals at the same rate regardless of 340B status.September 14, 2010—Medicare reimbursement to hospital outpatient facilities would rise by 2.2 percent overall in 2011 above this year's level, including a 2 percent increase in the payment rate for separately payable drugs and biologicals, the Centers for Medicare and Medicaid Services (CMS) have proposed. At the same time, however, CMS has called for a reduction in Medicare … [Read more...]
CMS Taps Just One Children’s Drug for New 17.1 Percent Medicaid Rebate
21 clotting factor products also qualify for lower rate.September 14, 2010—The Centers for Medicare and Medicaid Services (CMS) have decided that just one drug – MedImmune's Synagis (palivizumab), which is used to prevent serious lung infections in infants – meets the criteria for the new lower Medicaid rebate established for pediatric drugs under health care reform. The decision, which CMS announced in an Aug. 16 guidance … [Read more...]
CMS Plans To Withdraw AMP Rules Without a Timetable for a Replacement
Advises manufacturers to calculate prices in the meantime on health care reform language.September 14, 2010—The Centers for Medicare and Medicaid Services (CMS) proposed last week to withdraw its regulations and guidelines defining the average manufacturer price (AMP) of prescription drugs and advised pharmaceutical companies to temporarily determine those prices instead on language taken straight from the nation's new health care reform law. AMP is a key factor in … [Read more...]
Calif. Counties and Drug Firms Still Sparing Over 340B Records Disclosure
Companies are resisting Santa Clara plaintiffs' demands for more raw data on prices.September 14, 2010—Two California counties and the nine leading drug manufacturers they accuse of overcharging them for 340B-discounted drugs continued to exchange punches in federal district court in San Francisco this summer over the scope of discovery in the closely watched case. In Washington, meanwhile, the nation's highest court is preparing to decide whether to rule on a … [Read more...]