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This Week in Primary Care - March 3, 2023 

25 days ago

We are looking forward to seeing you all in DC next week for the NACHC P&I.  It’s an early spring, so you’ll get to see some cherry blossoms! 

In the meantime, here is this week’s newsletter, with an updated chart of Federal deadlines. It’s been a busy week in health policy, so there are several Key Takeaways:

  1. The Senate Health, Education, Labor, and Pensions (HELP) committee held a hearing yesterday on CHC funding.  The hearing featured three witnesses from the CHC world (including Ben from the Indiana PCA), a researcher who described how CHCs reduce total costs of care without reducing quality, and a Federal official with knowledge of CHC revenue sources.  The hearing was collegial, with most Senators expressing general support for continued CHC funding.  Sen. Cassidy (R-LA), the ranking member, asked several detailed questions about CHC funding, including how much comes from 340B, how much Medicaid pays CHCs compared to fee schedule providers, and how look-alikes can succeed without Federal grants.  The topics of 340B, workforce, and CHCs’ role in addressing behavioral health needs were raised several times.  See page 3.

  1. The House will not include any earmarks in the FY2024 Health Appropriations bill; the Senate is still accepting health-related earmark requests. See page 4.

  1. The North Carolina legislature reportedly has reached a deal to expand Medicaid, and while some procedural hurdles still remain, the Governor is eager to sign it into law.  If enacted, it will leave nine-non-expansion states.  Congratulations to the North Carolina PCAs and CHCs for their 11+ years of tireless advocacy to get to this point! See page 6.

  1. Drug maker Eli Lilly has announced that it will drop the price of its most-commonly prescribed insulin by 70%, and cap out-of-pocket costs for uninsured patients at $35 a month.  Counterintuitively, this move could increase CHCs’ costs to buy Lilly insulin products.  See page 6.

  1. The National Health Service Corps has started accepting applications for Loan Repayment.  The deadline is April 25.  See page 9.

There is only one Recommended Action Item this week, but it’s an important one:

Before Saturday March 11 (and ideally, before you leave for the P&I), please submit comments to CMS about how the agency should identify Medicare Part D prescriptions filled with 340B drugs.  CMS staff are leaning strongly towards requiring pharmacies to submit a modifier on all 340B claims – an approach that would undermine CHCs’ contract pharmacy arrangements, and the savings they generate.  Two templates for preparing your own comments – a “short” and “long” one -- are attached to this email.  See page 5.

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