340B Bill Would Hinder Administration’s Reforms
Another bill with bipartisan Senate support has been introduced to stop the administration from extending a rebate pilot it plans to launch that would convert 340B upfront discounts to retrospective rebates.
The bill would establish an independent, third-party data clearinghouse to address Big Pharma’s concerns that discounts are being diverted and duplicated by qualifying hospitals and other participants. The entity would coordinate 340B transaction data between parties and oversee any issues.
#340b #drugpricing #branddrugmakers #hospitals
https://www.fiercehealthcare.com/regulatory/new-bipartisan-340b-reform-bill-curbs-hhs-rebate-pilot
Rural Funding Stalled And Has Onerous Oversight
Rural hospitals complain that $50B in aid for rural healthcare is being stalled and subjected to onerous paperwork and regulatory oversight. Hospitals want the Centers for Medicare and Medicaid Services to create more flexibility around deadlines and funding caps.
(Article may require a subscription)
#ruralhealthcare #obbba #hospitals
https://www.modernhealthcare.com/providers/mh-cms-rural-health-transformation-program-red-tape
Wakely Dives Deep Into Exchange Financial Turmoil
A great white paper from Wakely going deep on the planned health plan exits, the impacts, and what remaining insurers need to understand about potential impacts. A few facts from the well-done (as usual) analysis:
- Nine Exchange plans have announced an exit across 23 states.
- This will impact 945,000 members.
- Four insurers will enter or expand.
- Remaining insurers will face new pricing, risk adjustment and operational challenges due to the enrollment impacts.
- Plans must evaluate pricing assumptions, network readiness, and member transition strategies.
Wakely says these times are the most challenging operating environments since the program’s early years.
#exchanges #healthplans #coverage
Fierce Healthcare Covers Q2 Health Plan Financials
Fierce Healthcare has a good review of Q2 financial outcomes for major health plans. The Q2 period was largely positive for the industry, signaling recovery with some caution. I covered the same topic in Thursday’s blog here: https://www.healthcarelabyrinth.com/are-insurers-turning-the-financial-corner-yes-but-there-is-more-work-to-be-done/ .
#healthplans #margins
— Marc S. Ryan
