340b – DeBrunner & Associates

Disagreement Over 340B’s Future

Almost immediately after the Department of Health and Human Services announced a pilot program to test using a rebate model in the 340B Drug Pricing Program, members of Congress responded with proposed legislation that would prevent HHS from implementing that pilot. Last week, HHS’s Health Resources and Services Administration announced its 340B Rebate Model Pilot Program, a refined version of a previous pilot program that a federal court rejected earlier this year. Under this new model, qualifying drug manufacturers will be able to provide the 340B ceiling price to eligible 340B providers through rebates, an approach manufacturers have increasingly sought, [...]

joe2026-08-11T15:58:28-04:00August 12, 2026|340b, hospitals|

HRSA Tries Again With New 340B Model

Following a federal court rejection earlier this year of a previously announced pilot program to alter how the 340B Drug Pricing Program is administered, the Department of Health and Human Services’ Health Resources and Services Administration has announced that it will implement a revised 340B Rebate Model Pilot Program. Under this new model, qualifying drug manufacturers will be able to provide the 340B ceiling price to eligible 340B providers through rebates, an approach manufacturers have increasingly sought, rather than the upfront discounts that providers prefer. According to a HRSA news release, the agency believes its new model will: Improve claims-level [...]

joe2026-08-06T15:15:39-04:00August 10, 2026|340b|

Federal Health Policy Update for August 6

Don’t Miss: CMS issues final FY 2027 Medicare inpatient payment regulation HRSA introduces revised 340B rebate model CMS gives states new tool to help identify non-citizen Medicaid applicants The following is the latest health policy news from the federal government for July 31 to August 6. Some of the language used below is taken directly from government documents. Congress The Senate is expected to vote on its version of a continuing resolution (CR) before leaving for recess; it would extend federal government funding through December 11. Notably, the legislation includes language that would prevent the Office of Management and Budget [...]

joe2026-08-06T17:32:05-04:00August 6, 2026|340b, Accountable Care Organization, ACO, Alternative payment models, Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, hospitals, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicare, Medicare disproportionate share, Medicare DSH, Medicare post-acute care, Medicare regulations, Medicare reimbursement policy|

More Medicaid DSH Money Coming for Some Hospitals?

Some hospitals may be in line for larger Medicaid disproportionate share hospital payments as a result of a federal court decision that calls for changes in how those Medicaid DSH payments are calculated. Last week, a U.S. District court in Texas again vacated a 2023 Centers for Medicare & Medicaid Services regulation that excludes inpatient days covered by uncompensated care pools, such as through section 1115 waivers, when quantifying Medicaid days for the purpose of calculating hospitals’ Medicaid DSH payments. This decision applies nationwide and has implications for the computation of some hospitals’ Medicaid DSH payments and for establishing hospitals’ [...]

joe2026-08-05T11:40:12-04:00August 6, 2026|340b, hospitals, Medicaid disproportionate share, Medicaid DSH|

Federal Health Policy Update for July 30

Don’t Miss: Two new final Medicare payment rules CMS seeks data on 340B prescriptions Agency seeks potentially confidential ER data The following is the latest health policy news from the federal government for July 24-30. Some of the language used below is taken directly from government documents. Congress Senate Republicans remain focused on advancing a short-term continuing resolution (CR) before the August recess; it is expected to differ from the CR the House passed last week. The Senate appears unlikely to consider a budget resolution for a third party-line reconciliation bill before September. The Senate Budget Committee announced a hearing [...]

joe2026-07-30T15:52:57-04:00July 30, 2026|340b, Affordable Care Act, Centers for Medicare & Medicaid Services, hospitals, MACPAC, Medicaid, Medicaid disproportionate share, Medicaid DSH, Medicaid regulations, Medicare, Medicare regulations, Medicare reimbursement policy|

Federal Health Policy Update for July 23

Don’t Miss: Congress advances health care bills CMS proposes provider tax rule Courts act on ACA changes, 340B The following is the latest health policy news from the federal government for July 17-23. Some of the language used below is taken directly from government documents. Congress The House Energy and Commerce Committee held a markup for 29 bills, advancing the following health care transparency measures with bipartisan support: H.R. 9390, Prices on the Wall Act of 2026 H.R. 9393, Lower Costs, More Transparency Act of 2026, part of a package that also includes: H.R. 3514, Improving Seniors’ Timely Access [...]

joe2026-07-23T16:29:15-04:00July 23, 2026|340b, Affordable Care Act, MACPAC, Medicaid managed care, Medicaid regulations, Medicare regulations, Medicare reimbursement policy, MedPAC|

Federal Health Policy Update for July 16

Don’t Miss: CMS proposed 2027 physician payment regulation House Ways and Means passes health care bills DHS publishes new, final public charge rule HHS pursues delivery models for potential psychedelic drugs for behavioral health treatment The following is the latest health policy news from the federal government for July 10-16. Some of the language used below is taken directly from government documents. CMS – Proposed 2027 Medicare Physician Fee Schedule Rule CMS has published its proposed physician fee schedule rule for 2027. Highlights include: A proposed reduction in Medicare physician rates. A reduction of payments for evaluation and management (E/M) [...]

joe2026-07-16T16:13:25-04:00July 16, 2026|340b, Accountable Care Organization, ACO, Alternative payment models, Congress, hospitals, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicaid regulations, Medicare, Medicare post-acute care, Medicare regulations, Medicare reimbursement policy|

Administration, Congress, Press Hospitals for Reforms

Even at a time when passing major health care legislation in the near future becomes increasingly unlikely, the hospital community continues to face serious challenges from both the administration and Congress. The Centers for Medicare & Medicaid Services has proposed making more Medicare outpatient payments on a site-neutral basis and reducing Medicare payments to hospitals for prescription drugs covered by the 340B drug pricing program. It also threatens other changes in the 340B program that hospitals believe will make it more difficult – and costly – to participate in. Meanwhile, Congress is considering increasing federal oversight of the finances of [...]

joe2026-07-07T16:42:00-04:00July 8, 2026|340b, hospitals, Medicaid, Medicaid regulations|

Proposed Medicare Rule Could Hit Hospitals Hard

The Centers for Medicare & Medicaid Services’ proposed 2027 Medicare outpatient prospective payment system rule could pose several serious challenges to hospitals. Among them: A proposed increase of 2.4 percent in payments for outpatient services that could be reduced to only 0.6 percent if CMS adopts its proposal to accelerate its clawback from previous 340B litigation to a three percent reduction. The transition of still more imaging services to site-neutral payments and a prohibition against Medicare outpatient payments for off-campus hospital-based outpatient departments unless each department has its own National Provider Identifier (NPI) and an attestation from the main provider [...]

joe2026-07-07T12:02:42-04:00July 7, 2026|340b, hospitals, Medicare regulations, Medicare reimbursement policy|

Federal Health Policy Update for July 2

Don’t Miss: CMS proposes CY 2027 Medicare outpatient rates, reviving 340B cuts, expanding site-neutral payments CMS calls for modest Medicare home health pay hike, more ways to oust providers Court halts borrowing limit that jeopardized supply of qualified health professionals The following is the latest health policy news from the federal government for June 25-July 2. Some of the language used below is taken directly from government documents. Proposed CY 2027 Medicare Outpatient Prospective Payment and Ambulatory Surgical Center Rule CMS has published its proposed Medicare FY 2027 outpatient and ambulatory surgical center prospective payment system rule. The proposed [...]

joe2026-07-02T16:55:39-04:00July 2, 2026|340b, Accountable Care Organization, Affordable Care Act, Centers for Medicare & Medicaid Services, hospitals, Medicare, Medicare post-acute care, Medicare regulations, Medicare reimbursement policy|