Trump Administration Sides With Hospitals Over Drug Makers in 340B Lawsuit
The Department of Health and Human Services (HHS) has filed for summary judgment in its favor regarding lawsuits on the 340B program, siding with hospitals over drug makers. This is consistent with the Biden administration. While I am not a fan of brand drug makers, it is clear that hospitals and some other providers are abusing the intent of the program. Trump is on the wrong side of this policy issue.
#340b #drugpricing #branddrugmakers
Rising Hospital Margins
Hospitals across the nation logged a monthly median operating margin of 4.4%, up from 3.7% in December and 2.1% reported for all of 2024.
#hospitals #margins
MedPAC Wants Medicare Provider Rate Hikes
MedPAC, the congressional policy arm, has recommended tying the rate of physician and other health professionals’ payment increases in 2026 to the Medicare Economic Index minus 1 percentage point. Of course, Medicare physicians have waited for decades for a permanent physician fee formula. It just got a 2.8% decrease in 2025.
#medicare #physicians #rates
Site Neutral Payments Could Be Considered
While they have not galvanized a lot of interest recently, the sheer magnitude of budget cut goals could usher forward consideration of Medicare site neutral payment reforms. It would be great for both Medicare and commercial costs, which are based on Medicare for the most part.
(Article may require a subscription.)
#siteneutral #medicare #employercoverage
https://www.modernhealthcare.com/politics-policy/site-neutral-legislation-policies-tax-cuts
BCBS Plans Gain Medicare Advantage Lives
Perhaps at the wrong time, Blue Cross and Blue Shield plans are gaining enrollment in the Medicare Advantage (MA) market as some national plans contract their footprints. But it comes at a volatile time for the MA program and could cost these plans a great deal.
(Article may require a subscription.)
#medicareadvantage #enrollment #rates
https://www.modernhealthcare.com/insurance/bcbs-blue-cross-medicare-advantage-market
KFF Issues FWA Primer
As the GOP considers focusing spending reductions on Medicaid on fraud, waste, and abuse (FWA), health policy foundation KFF has published a primer discussing what program integrity is all about in the state-federal partnership.
#fwa #medicaid #budgetreconciliation
— Marc S. Ryan
