340B – DeBrunner & Associates

Federal Health Policy Update for September 18

The following is the latest health policy news from the federal government for September 12-18. Some of the language used below is taken directly from government documents. Congress Funding for the federal government expires on September 30. Members of Congress have not yet coalesced around a plan to fund the federal government when the new federal fiscal year begins on October 1, with House Republican and Democratic leaders releasing competing legislative texts for a short-term continuing resolution (CR). House Republicans have proposed a CR to last through November 21 with very few anomalies, or policy changes, outside of regular spending. [...]

joe2025-09-18T17:11:02-04:00September 18, 2025|340b, Affordable Care Act, Congress, hospitals, Medicaid, Medicaid disproportionate share, Medicaid DSH, Medicaid DSH allotments, Medicaid managed care, Medicaid regulations, Medicare, Medicare disproportionate share, Medicare DSH, Medicare regulations, Medicare reimbursement policy, post-acute care, Telehealth|

Providers Objecting to New HHS Programs

Health care providers are expressing concern about two new programs recently announced by the Department of Health and Human Services: the Centers for Medicare & Medicaid Services’ Medicare WISeR (Wasteful and Inappropriate Service Reduction) Model and HHS’s 340B Rebate Model Pilot Program. The WISeR model, to be tested in six states, will require doctors to obtain prior authorization before providing a limited group of services. That prior authorization is expected to be delivered primarily through the use of AI. Participation will be mandatory in the states involved in the program and providers are concerned that it will increase their administrative [...]

joe2025-09-17T12:50:36-04:00September 18, 2025|340b, Center for Medicare and Medicaid Innovation, CMMI, Medicare, Medicare reimbursement policy|

Federal Health Policy Update for September 11

The following is the latest health policy news from the federal government for September 5-11. Some of the language used below is taken directly from government documents. Congress With fewer than three weeks until the end of the federal fiscal year, congressional leaders are beginning to devise a strategy to avoid a federal government shutdown on October 1. Whatever strategy they ultimately adopt will certainly involve some form of continuing resolution (CR). Some conservatives in Congress would like to see a full-year CR that would keep funding at current levels and permit the President to cut spending via rescissions. Appropriators [...]

joe2025-09-11T16:41:56-04:00September 11, 2025|340b, Affordable Care Act, Congress, hospitals, Medicaid, Medicaid disproportionate share, Medicaid DSH, Medicaid DSH allotments, Medicare, Medicare regulations, Medicare reimbursement policy, Telehealth|

Federal Health Policy Update for August 14

The following is the latest health policy news from the federal government for August 8-14. Some of the language used below is taken directly from government documents. Congress The House and Senate are both in recess and will return to Washington D.C. on September 2. Funding for the federal government, along with health care extenders including extensions of telehealth flexibilities, the Acute Hospital Care at Home program, the Medicare-dependent hospital and low-volume hospital programs, and delays to Medicaid disproportionate share (Medicaid DSH) allotments, all expire September 30. In the fall, Congress is considering pursuing health care legislation along two tracks, [...]

joe2025-08-14T15:35:41-04:00August 14, 2025|Centers for Medicare & Medicaid Services, hospitals, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicaid disproportionate share, Medicaid DSH, Medicaid DSH allotments, Medicare, Medicare post-acute care, Medicare reimbursement policy, Telehealth|

Federal Health Policy Update for August 7

The following is the latest health policy news from the federal government for August 2-7. Some of the language used below is taken directly from government documents. Congress The House and Senate are both in recess. When Congress returns in September its top priority will be funding the federal government before the fiscal year ends on September 30, likely requiring a continuing resolution to avoid a shutdown. Several major health care programs and extenders are set to expire at the end of the fiscal year, including Medicaid disproportionate share (Medicaid DSH) allotments, telehealth flexibilities, the Acute Hospital Care at Home [...]

joe2025-08-07T15:29:33-04:00August 7, 2025|340b, Congress, COVID-19, hospitals, Medicaid, Medicaid disproportionate share, Medicaid DSH, Medicaid DSH allotments, Medicare, Medicare reimbursement policy, Telehealth|

Federal Health Policy Update for July 3

The following is the latest health policy news from the federal government for June 27 – July 3. Some of the language used below is taken directly from government documents. Congress/Budget Reconciliation After more than 36 hours of intense lobbying by the administration and House Republican leadership and an all-night legislative session that carried well into Thursday afternoon, the House approved the Senate-passed version of H.R. 1, the reconciliation bill, by a vote of 218-214. Voting was almost entirely along party lines, with all House Democrats voting against it and just two Republicans – Brian Fitzpatrick (PA) and Thomas Massie [...]

joe2025-07-03T16:02:05-04:00July 3, 2025|340b, Affordable Care Act, Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, COVID-19, MACPAC, Medicaid, Medicaid disproportionate share, Medicaid DSH, Medicaid DSH allotments, Medicaid managed care, Medicaid regulations, Medicare, Medicare reimbursement policy|

HHS Releases Proposed Budget

The Department of Health and Human Services has released a new, expanded version of its proposed FY 2026 budget. In some areas this version provides more detail than the administration shared in early May when it released a so-called “skinny budget” and some aspects of the budget proposal differ from the May release. Highlights of the most recent proposal include: A reduction of 25 percent, from $126 billion to $94.7 billion, in HHS’s overall discretionary (non-mandatory) spending. The consolidation of HHS’s 28 current operating divisions into 15 divisions. A reduction of $661 million, or 11 percent, in discretionary spending for [...]

joe2025-06-11T12:29:44-04:00June 12, 2025|340b, Centers for Medicare & Medicaid Services|

Federal Health Policy Update for May 22

The following is the latest health policy news from the federal government for May 16-22. Some of the language used below is taken directly from government documents. Congress: Reconciliation Early Thursday morning the House of Representatives passed its version of an FY 2025 budget reconciliation bill by a vote of 215-214. The bill underwent a number of changes during the hours before its passage and its health care provisions now include $800 billion in Medicaid cuts over the next ten years. The Congressional Budget Office projects that the bill, mostly because of the Medicaid cuts, will lead to 8.6 million [...]

joe2025-05-23T10:22:33-04:00May 23, 2025|340b, Affordable Care Act, Centers for Medicare & Medicaid Services, COVID-19, deficit reduction, hospitals, Medicaid, Medicaid disproportionate share, Medicaid DSH, Medicaid DSH allotments, Medicaid managed care, Medicaid regulations, Medicare, Medicare reimbursement policy|

Committee Chair Calls for 340B Changes

In a newly released report, Senate Health, Education, Labor and Pensions (HELP) Committee chair Bill Cassidy (R-LA) has pointed to problems with the 340B Drug Pricing Program and suggested ways of dealing with those problems. The report, from the committee’s majority staff, notes that … there are concerns about whether the 340B Program truly benefits low-income and uninsured patients, with some studies suggesting that the 340B benefit does not translate into increased care or lower costs for vulnerable populations. It also outlines potential changes for improving the program, including requiring additional reporting on the use of 340B savings, scrutiny of [...]

joe2025-04-29T16:30:28-04:00April 30, 2025|340b, Congress, Medicaid|

Federal Health Policy Update for April 17

The following is the latest health policy news from the federal government for April 11-17. Some of the language used below is taken directly from government documents. The White House President Trump signed an executive order titled “Lowering Drug Prices by Once Again Putting Americans First” that directs the Secretary of the Department of Health and Human Services to take steps to lower prescription drug costs for patients. The order addresses several prescription drug-related policies, including: the Medicare Drug Price Negotiation Program seeking better Medicare prices for drugs not subject to the Medicare Drug Price Negotiation Program accelerating FDA drug [...]

joe2025-04-17T17:14:31-04:00April 17, 2025|340b, Accountable Care Organization, ACO, Alternative payment models, Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, Congress, hospitals, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicare, Medicare reimbursement policy|