Despite the Hospital Transparency Rule being in effect, the majority of 340B hospitals are not reporting their prices for top services and drugs, and those that have, reported on “egregious” markups, said Ted Okon, MBA, executive director, Community Oncology Alliance.
Despite the Hospital Transparency Rule being in effect, the majority of 340B hospitals are not reporting their prices for top services and drugs, and those that have, reported on “egregious” markups, said Ted Okon, MBA, executive director, Community Oncology Alliance (COA).
Transcript
The Hospital Transparency Rule has been in effect for over a year now, and COA has pointed out the widespread failure of many 340B hospitals to follow this rule. Where do you go from here?
HHS requires that hospitals disclose, in an easy manner, basically, their prices on top services and drugs. And last year, when [COA] had [Dr] Ronny Gal's Moto [Bio]advisors look at this, we found that of the over 1000 340B hospitals, only 11% were reporting their data. What that showed, though, with that 11% is they're marking up drugs 3.8 times. Not 3.8%, 3.8 times. And that's just egregious, especially when they have these 340B discounts.
So, the end result of that is that we now see more hospitals reporting; we're actually doing a 2.0 version of that report from last year. But you still don't have a lot of the top 340B hospitals that report. Why? Because they make so much money on these drugs and they mark them up, they don't want to show that. And the interesting thing is just recently, we've seen HHS hand out the first 2 fines to 2 Atlanta hospitals that basically have not reported. I think you'll see more pressure on HHS to hand out those fines, but frankly, if a hospital is making $350 million, $400 million a year, which some of the top hospitals are in 340B discounts, getting a fine of $2 million, $3 million a year is the price of doing business.
But this hospital transparency data is really waking a lot of people up as to how much money these hospitals are making on 340B and not literally passing the discounts on to patients, or using that to advance charity care. In many cases, their charity care has gone as their profits from 340B have gone up.
CMS released a final rule to help patients obtain Children’s Health Insurance Program (CHIP) coverage and issued a proposed rule to update Medicare payment policies and rates for inpatient rehabilitation facilities; debate over if gift card incentives are acceptable in health care marketing.
Read More
Exploring Medicare Advantage Prior Authorization Variations
March 26th 2024On this episode of Managed Care Cast, we're talking with the authors of a study published in the March 2024 issue of The American Journal of Managed Care® about their findings on variations in prior authorization use across Medicare Advantage plans.
Listen
What We’re Reading: HHS' Funding Flat; Mifepristone Safety; Insulin Shortage
March 25th 2024Flat funding for HHS leaves critical health initiatives stagnant; Supreme Court weighs tightening regulations on abortion pill; manufacturing delay sparks access concerns for insulin medication.
Read More
Health Equity and Access Weekly Roundup: March 23, 2024
March 23rd 2024The Center on Health Equity and Access covered disparities in hypertension, diabetic eye health, and hidradenitis suppurativa, along with the proposed legislation banning diversity, equity, and inclusion efforts in Alabama schools and the consequences in sickle cell care from the CDC guideline for opioid prescriptions.
Read More
Dr Al Benson on Reimbursement for Supportive Care When Treating Patients With Cancer
March 22nd 2024Al Benson, MD, FACP, FACCC, FASCO, medical oncologist at Northwestern University Feinberg School of Medicine and associate director of the Robert E. Tillery Comprehensive Cancer Center, discussed findings from a national survey assessing barriers to comprehensive cancer care delivery.
Read More