Ep 51 | CMS Medicaid Drug Rebate Program & “Covered Outpatient Drug” Definition
340B Unscripted21 Elo 2024

Ep 51 | CMS Medicaid Drug Rebate Program & “Covered Outpatient Drug” Definition

In this episode, Greg and Rob are joined by healthcare attorney Todd Nova to discuss a proposed rule change put forth by CMS in 2023 regarding the Medicaid Drug Rebate Program (MDRP), which includes a potential change to the definition of “covered outpatient drug”. They’ll discuss how covered entities have historically interpreted the definition of covered outpatient drugs, and what impact might come from CMS’s proposed change in this definition. Greg and Rob also get Todd’s take on recent HRSA audit activity in a post-Genesis 340B environment.

In the intro, the guys discuss the recent announcement of Medicare prices on the first 10 drugs subject to IRA-mandated drug price negotiations, a court ruling in Texas over DSH% calculation and use of Section 1115 waiver days, and changes to claims submission via 340B ESP.

Jaksot(91)

Ep 45 | Chevron Doctrine & 340B

Ep 45 | Chevron Doctrine & 340B

In this episode, Greg and Rob are joined by healthcare attorney Ross Marguiles to discuss how a Supreme Court ruling on litigation in the fishing industry could have a major impact on the healthcare l...

22 Touko 202454min

Ep 44 | Pharmacotherapy Clinic Services & 340B

Ep 44 | Pharmacotherapy Clinic Services & 340B

In this episode, SpendMend colleague Matt Parker joins Greg and Rob (14:00) to discuss pharmacotherapy services, and how pharmacist-driven care can help promote improved health outcomes in a community...

6 Touko 202453min

Ep 43 | Getting to Know the HRSA DRL – DRL 8 Self-Disclosure Documentation and DRL 9 Medicaid Billing Information

Ep 43 | Getting to Know the HRSA DRL – DRL 8 Self-Disclosure Documentation and DRL 9 Medicaid Billing Information

In this episode, Greg and Rob continue to provide insights on the HRSA data request list.   DRL #8 is self-disclosure documentation and DRL #9 is Medicaid billing information, which includes providing...

22 Huhti 202451min

Ep 42 | Getting to Know the HRSA DRL – Grantee Considerations Part 2

Ep 42 | Getting to Know the HRSA DRL – Grantee Considerations Part 2

SpendMend colleagues Jasmine and Megan continue their conversation providing some grantee CE perspectives concerning the HRSA DRL.

15 Huhti 202444min

Ep 42 | Getting to Know the HRSA DRL – Grantee Considerations Part 1

Ep 42 | Getting to Know the HRSA DRL – Grantee Considerations Part 1

In this episode, SpendMend colleagues Jasmine and Megan provide some grantee CE perspectives concerning the HRSA DRL.  They have so much great insight, we are breaking this conversation up into two pa...

8 Huhti 202448min

Ep 41 | 340B News & Notes

Ep 41 | 340B News & Notes

In this episode, Rob and Greg catch up on a cluster of developments in the 340B space, including updates to manufacturer contract pharmacy restrictions, thoughts on a federal appellate court ruling on...

25 Maalis 202429min

Ep 40 | Getting to Know the HRSA DRL: DRL 5 Purchasing Documentation and DRL 7 Entity-Owned Pharmacy Documentation

Ep 40 | Getting to Know the HRSA DRL: DRL 5 Purchasing Documentation and DRL 7 Entity-Owned Pharmacy Documentation

In this episode, Greg and Rob continue reviewing data solicited by HRSA during an audit. DRL #5 is purchasing documentation, including a list of accounts, sample invoices, and 340B purchase order deta...

11 Maalis 202448min

Ep 39 | A Revisit of Ongoing Contract Pharmacy Restrictions

Ep 39 | A Revisit of Ongoing Contract Pharmacy Restrictions

In this episode, Greg and Rob are once again joined by SpendMend team member Riley Protz, to catch up on the current state of ongoing manufacturer restrictions on 340B contract pharmacy operations, as...

26 Helmi 202432min

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