Good Afternoon Members,
It's been a very active week in policy, in terms of both Federal funding and 340B issues. There are several Key Takeaways this week (but no Recommended Action Items):
1. Since the "minibus" spending bill (which has already passed the House and is expected to pass the Senate this afternoon) extends Section 330, NHSC, & THC funding only through December 31, it is effectively a short-term patch. The big battle over long-term funding is expected to come during the lame duck session, when a large bill addressing many health care provisions (e.g., Medicare telehealth coverage, PBM reform) is expected to move. Hopefully the CHC/NHSC/THC increases in the minibus will become the new "floor" for negotiating increases this December. See pages 3-4.
2. Claims linking 340B to illegal immigration are escalating and spreading. For example, the National Review described the program as a "$340 billion program to provide health care for illegal immigrants", and similar arguments are being used to pressure the Virginia governor to veto the bill banning contract pharmacy restrictions against CHCs, even though the legislature recently approved it overwhelmingly. See page 4.
3. There's been extensive activity this week around state 340B bills advanced by PCAs. Unfortunately, Arizona and Idaho's bills around contract pharmacy restrictions (CPRs) look dead for this session, but Kentucky's and West Virginia's CPR bills both passed a full chamber with strong margins. Also, South Dakota enacted a new bill to strengthen its 2019 pick-pocketing bill. See page 7.
4. A twelfth manufacturer has announced contract pharmacy restrictions on CHCs – with two new twists. First, the manufacturer has only one drug, and it's still awaiting FDA approval. Second, to have access to 340B pricing for this drug at even a single contract pharmacy (CP), the CHC must agree to submit data to ESP. As the new product will be considered a "specialty" drug, many CHCs with in-house pharmacies will still need to rely on a CP to access the drug. CHCs must designate their single CP site by March 22 in order to have it effective by April 1. See page 6.
5. Two updates regarding Federal 340B legislation:
• Comments from Colleen Meiman on the discussion draft of the Senate 340B reform bill and RFI will be shared early next week, along with several templates that PCA and CHCs can adapt for their own use if desired. The two most important points will be:
o Ensuring access to specialty drugs via multiple, out-of-area contract pharmacies.
o Ensuring that all CHCs can fill all specialist and discharge all prescriptions for their eligible patients.
Apologies in advance for the length of the full comments, but as with all things 340B, the devil is in the details. See page 5.
• The ASAP 340B bill is expected to be formally introduced in Congress soon. Vacheria at NACHC shared a high-level overview with PCAs this week. See page 6.
6. Once the minibus is passed, Certified Community Behavioral Health Care (CCBHC) services will become an optional Medicaid benefit in all states. See page 9.
We thank you for your continued advocacy on these federal and state issues.
If you have any questions, please feel free to reach out at any time.