09 Mar Journal Gazette: PAUSE Act ill-serves patients
“For 25 years, the 340B Drug Pricing Program has made a difference in the lives of millions of Americans. The relatively unknown program, started in 1992, reduces the cost of drugs for many hospitals and providers who serve low-income, underinsured or uninsured patients.
It was simple: Drug manufacturers discounted outpatient drugs for these entities in return for a guaranteed share of the lucrative Medicaid market. These discounts – perhaps as much as 50 percent off drug prices – allowed authorized hospitals to stretch all-too-scarce resources, treat more patients and provide better service.
But 2017 was a challenging year for the 340B program, and 2018 is shaping up to be even more so. Proposed changes are simply the backdrop to other major systemic transformations that will add clinical and financial strains to an already-beleaguered health care system.
Last Nov. 1, the Centers for Medicare and Medicaid Services issued a final ruling that included disastrous changes for reimbursement in the 340B program. The ruling mandated that Medicare Part B payments to 340B hospitals be slashed by nearly a third. The loss of these savings threatens patient care by forcing hospitals to cut back on important services.
Now, the 340B program could be hit by even worse changes, associated with legislation introduced by Rep. Larry Bucshon, R-8th – House Resolution 4710, the “340B Protecting Access for the Underserved and Safety-net Entities Act,” known as the 340B PAUSE Act. The act would implement further changes to the 340B program as it applies to disproportionate share hospitals, and cancer and children’s hospitals.
The changes and the bill’s name are misguided and would not protect access, but erode it.”