November 2025

HHS Sets 340B Rebate Model

The Department of Health and Human Services’ Health Resources and Services Administration has approved eight plans from pharmaceutical companies to participate in its 340B Rebate Model Pilot Program. Currently, eligible 340B providers receive discounts when they purchase covered drugs but under the rebate model, covered entities continue to make purchases through their 340B wholesaler and will seek rebates from the pharmaceutical companies for the ten affected drugs dispensed to 340B-eligible patients after a purchase is made. Providers argue that the new approach creates a new, significant administrative burden for them and could affect their cash flow while pharmaceutical companies maintain [...]

2025-11-05T12:45:32-05:00November 6, 2025|340b|

New Methodology Helps Facilitate Medicaid Renewals

When the end of the COVID-19 pandemic led to the end of the moratorium on Medicaid disenrollments, states faced a daunting challenge:  how to redetermine eligibility for 90 million people on their Medicaid rolls. The challenge grew even greater when it appeared that significant numbers of people were losing their Medicaid eligibility not because they no longer met the program’s eligibility criteria but for procedural reasons such as inability to  gather the information needed to demonstrate eligibility, incomplete applications, or missing application deadlines. To address this problem, the Centers for Medicare & Medicaid Services tried a different approach, working with [...]

2025-11-04T16:35:21-05:00November 5, 2025|Centers for Medicare & Medicaid Services, COVID-19, Medicaid|
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