340B policies in OPPS rule draw hospital concerns
A proposed cut in Medicare payments for 340B drugs and an acceleration in repayments related to a previous 340B cut are leading concerns for some hospitals and health systems. The two 340B policies in the proposed rule for the outpatient prospective payment system (OPPS) were among a range of provisions in the 299-page rule issued…
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…
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…
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.
Hospitals, insurers clash on 340B rebate costs
Hospitals and insurers both urged federal regulators to ignore the cost projections of the other side in their comments on a coming redux of a 340B rebate model. The comments came in response to a request for information (RFI) from the Health Resources and Services Administration (HRSA) seeking input on whether and how to implement…
Federal 340B overhaul bill unlikely this year
A bipartisan Senate effort at 340B program reform is likely dead this Congress, according to lobbyists and policy watchers. The so-called gang of six group of senators has been working on an overhaul of the program since 2024 that aims to address concerns of both providers and drugmakers. However, that effort has not advanced beyond…
Minnesota hospitals: 340B revenue from drugmaker profits
The $1.3 billion Minnesota providers garnered in 2024 from the 340B program was money that would have gone to drugmaker profits, states the hospital group. The latest state-mandated report on Minnesota covered entities’ earnings from 340B found: The increase from 2023 to 2024 primarily stemmed from the latest report adding office-administered drugs by covered entities,…
How a looming federal mandate will affect hospitals
Nick and Shawn discuss appropriations efforts and how various provisions will affect hospitals, specifically in outpatient department claims. Note: After the recording of this episode, the parties hit a roadblock on the bill that was the main topic of discussion. Check out our news coverage for the latest.
FastFinance: Texas sues Epic; 340B lawsuit update
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. A list of alleged financial harms against hospitals are at the heart of Texas’ anticompetitive lawsuit again EHR vendor Epic. Learn why its details are required reading. Also, this week’s Weird…