Noteworthy News

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House Members to CMS: Don’t Cut 340B Payments

More than half of the members of the House of Representatives have written to CMS administrator Seema Verma asking her to withdraw a controversial proposal that would greatly reduce Medicare reimbursement for prescription drugs for urban safety-net hospitals and other safety-net providers that serve large numbers of low-income patients.. At issue are proposed changes in the federal section 340B prescription drug discount program – changes that would drastically reduce payments to participating hospitals for the prescription drugs they provide to low-income outpatients.  Savings from the program help underwrite services and outreach for low-income patients. The letter to CMS administrator Verma [&hellip

House Members Seek Delay of DSH Cuts

221 members of the House of Representatives have written to House leaders asking them to delay cuts in Medicaid disproportionate share payments (Medicaid DSH) that are scheduled to begin on October 1. The cuts, mandated by the Affordable Care Act, have already twice been delayed by Congress, both times for two years, and now, a majority of House members have written to House speaker Paul Ryan and minority leader Nancy Pelosi asking them to advance legislation to delay Medicaid DSH cuts once again. The purpose of Medicaid DSH payments is to help hospitals that serve especially large numbers of low-income [&hellip

House Committee Looks at 340B

Are hospitals using the savings generated by their participation in the section 340B prescription drug discount program to help their low-income and uninsured patients? That’s what the House Energy and Commerce Committee’s Health Subcommittee is asking. Earlier this year the committee requested such information from the Health Services and Resources Administration, which runs the 340B program, and now it’s asking hospitals as well. Specifically, the subcommittee sent five-page letters to 19 providers that participate in the 340B program asking them about: the quantity of 340B-purchased drugs they dispense to Medicare beneficiaries, Medicaid beneficiaries, and those with private insurance the quantity [&hellip

MedPAC Comments on Proposed Medicare Outpatient Payment Rule

The Medicare Payment Advisory Commission has weighed in with the Centers for Medicare & Medicaid Services on its proposed regulation governing the 2018 hospital outpatient prospective payment system and ambulatory surgical center payment systems and quality reporting programs. Among the issues MedPAC addresses in its comment letter to CMS are the proposal to reduce Medicare reimbursement for 340B-covered prescription drugs; how to reinvest the savings such a payment cut would produce; the ability of hospitals to expand the services they offer at hospital-based outpatient departments; proposed changes in the Medicare hospital outpatient quality reporting program and ambulatory surgery center quality [&hellip

Overutilization of ERs May Not be as Great as Perceived

Far fewer hospital emergency room visits are for medical problems better addressed in other settings, according to a new study. In a review of six years worth of data encompassing 424 million ER visits, researchers found that only 3.3 percent of those visits were truly “avoidable,” with the avoidable visits mostly involving problems ERs are not equipped to address, such as dental and mental health issues. This finding flies in the face of the conventional wisdom that people turn too quickly to hospital ERs for routine medical problems or use ERs because they lack access to more appropriate care. Learn [&hellip

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