340B – DeBrunner & Associates

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 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|

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|

House Weighs Hospital Transparency Bill

A new bill in the House of Representatives would require most non-profit hospitals to provide more detailed financial information to the federal government to justify their continued tax-exempt status. The Tax Exempt Hospital Transparency Act, currently working its way through the House Ways and Means Committee, would apply, in general, to non-profit hospitals and hospital organizations with more than 100 staffed beds and more than $100 million in patient revenue. Affected tax-exempt hospitals would be required to report annually on how they have addressed the needs identified in their required community needs assessment – and explain why they are not [...]

joe2026-07-01T12:09:31-04:00July 2, 2026|340b, Congress, hospitals|

Federal Health Policy Update for June 25

Don’t Miss: CMS posts a new presentation on Medicaid eligibility under HR 1 House health subcommittee marks up health care price transparency bills Cassidy proposes 340B bill HRSA announces two maternity-related funding opportunities The following is the latest health policy news from the federal government for June 19-25. Some of the language used below is taken directly from government documents. Congress The House Energy and Commerce Committee’s Oversight Subcommittee held a hearing to discuss integrity and fraud risk in state Medicaid programs; witnesses included state Medicaid directors from California, Minnesota, New York, and Ohio. For more information, see the press [...]

joe2026-06-25T17:28:47-04:00June 25, 2026|340b, Centers for Medicare & Medicaid Services, Congress, hospitals, MACPAC, Medicaid, Medicare, Medicare regulations, Medicare reimbursement policy|

Federal Health Policy Update for June 18

Don’t Miss: 340B Rebate Model pilot program – next steps Stricter rules on CMS’s reviews of new and existing section 1115 Medicaid demonstration programs Changes in health care institution accrediting practices HHS posts mental and behavioral health grant opportunities The following is the latest health policy news from the federal government for June 12-18. Some of the language used below is taken directly from government documents. Congress Both chambers of Congress will return to session on June 22. The House Energy and Commerce Committee’s Oversight and Investigations Subcommittee will hold a hearing titled “State Medicaid Program Integrity: Examining Fraud Risks [...]

joe2026-06-18T16:07:51-04:00June 18, 2026|340b, Affordable Care Act, Alternative payment models, hospitals, MACPAC, Medicaid, Medicaid and CHIP Payment and Access Commission, Medicaid managed care, Medicaid regulations, Medicare, Medicare regulations, Medicare reimbursement policy, MedPAC|

A 340B Scorecard

Hospitals suing CVS Health over 340B savings. The Health Resources and Services Administration’s proposed 340B Rebate Model Pilot Program. Eli Lilly’s demand that hospitals share claims-level data for 340B-covered drugs. The continuing battle over the involvement of contract pharmacies in providing access to 340B-covered drugs. Sometimes it seems as if barely a week passes without some new challenge to the 340B program. In a recent article, Becker’s Hospital News presents an update on the latest in challenges to the 340B program. Learn more from its article “340B in 2026: Tracking litigation, mandates and policy shifts reshaping the program.”

joe2026-06-03T12:31:11-04:00June 4, 2026|340b|

Federal Health Policy Update for April 10

The following is the latest health policy news from the federal government for April 4-10. Some of the language used below is taken directly from government documents. Congress The House and Senate were in recess this week and are scheduled to be back in session on April 14. House Speaker Mike Johnson (R-LA) has indicated that the House will not vote on the Senate‑passed Department of Homeland Security continuing resolution until there is meaningful progress on a reconciliation package to fund U.S. Immigration and Customs Enforcement (ICE) and U.S. Customs and Border Protection. In an effort to narrow the scope [...]

joe2026-04-10T13:43:20-04:00April 10, 2026|340b, Center for Medicare and Medicaid Innovation, Centers for Medicare & Medicaid Services, CMMI, Congress, Medicaid, Medicare, Medicare disproportionate share, Medicare DSH, Medicare reimbursement policy|