J&J adds 340B claims data requirements amid growing manufacturer restrictions
Johnson & Johnson joined the list of drug manufacturers requiring providers to submit claims data on in-house pharmacy drugs as a condition of receiving discounts in the 340B Drug Pricing Program. Hospitals and other 340B covered entities have 45 days to submit the data after dispensing a covered drug, according to J&J’s policy, although certain…
Leading without authority, with Dave Sanderson
Dave Sanderson, CEO of Resilience Partners Group, became a leader the day a routine flight he was on made history as the “Miracle on the Hudson.” Now, Sanderson, who spent much of his career in healthcare, coaches people on how they can choose leadership, even when they’re not in charge. Also in this episode, Nick…
FastFinance: Capex trends; new 340B bill
HFMA’s FastFinance newsletter is now a podcast. Host Rich Daly discusses the most current and relevant healthcare news, delivered in an easily digestible format. Hospital and health system capital expenditures in fiscal 2025 reached their highest since the start of the financial crisis in 2008, according to Fitch Ratings Also, this week’s Weird Number: $137…
Medicare DSH payments ruling could boost hospital reimbursement under 1115 waivers
Hospitals obtained a victory in a case about Medicare disproportionate share hospital (DSH) payments, with potentially significant reimbursement implications. In a July 27 ruling in Covenant Medical Center v. Kennedy, a judge with the U.S. District Court for Northern Texas struck down an HHS rule that excluded certain patients from the DSH formula if they were…
SUSTAIN 340B Act proposes major changes for hospitals and pharmacies
A bipartisan working group in Congress released a preliminary legislative draft that attempts to resolve some of the most disputed aspects of the 340B Drug Pricing Program. One noteworthy provision in the legislation would curtail the 340B rebate model, which was finalized by the Health Resources and Services Administration on July 31 and is scheduled to begin Jan.…
HRSA sets 2027 launch for the 340B rebate model, announces requirements
The Health Resources and Services Administration (HRSA) followed through with plans to pilot a rebate model for the 340B Drug Pricing Program beginning Jan. 1, 2027. As described in a notice published July 31, HRSA previously scrapped plans for a 2026 pilot following litigation. In response to that legal challenge, the agency provided additional information…
What appeals court 340B rebate decision means for federal rebates
An appeals court barred 340B rebate programs by drug manufacturers, among recent legal developments. The case could have ramifications for federal 340B rebates. On July 21, the U.S. Court of Appeals for the D.C. Circuit upheld a lower court ruling that barred alternative 340B rebate models without explicit approval from HHS. “That’s certainly welcome news…
House bill would increase tax-exempt hospital reporting requirements
A bill that advanced out of a House committee Wednesday would add significant reporting requirements for tax-exempt hospitals. As passed by the Ways and Means Committee, the Tax-Exempt Hospital Transparency Act includes increased reporting obligations in areas such as community benefit, charity care, the 340B Drug Pricing Program and service-line spending. Requirements would be more…
Utilization review, HIPAA updates and more
Nick Hut talks with HFMA’s Kathy Stull about the Medicaid work requirement and 340B developments. Erika Grotto discusses utilization review with Kevin Coloton, CEO of HURC and HIPAA updates with Jon Bilotti, enterprise technology consultant at BCS365.
340B bill would levy various restrictions on participating hospitals
Legislative language overhauling the 340B Drug Pricing Program faces a long and uncertain path in Congress but would have significant implications if some of the provisions become law. A preliminary bill draft released by Sen. Bill Cassidy (R-La.) would tighten oversight of hospitals and contract pharmacies, increase transparency and require 340B discounts to be transferred…