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

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Avsnitt(99)

Ep 93 |  340B Patient Definition

Ep 93 | 340B Patient Definition

Rob and Greg are joined by healthcare attorney Mark Ogunsusi to discuss 340B patient definition, including the 1996 HRSA guidance, key regulatory developments over the years, and the impact that recen...

15 Juni 1h 9min

Ep 92 | Latest 340B Updates

Ep 92 | Latest 340B Updates

In this week’s episode, Greg and Rob discuss developments across the 340B community, including new manufacturer claims level data submission policies and ongoing discussion in Congress on 340B Program...

18 Maj 23min

Ep 91 | More 340B Updates

Ep 91 | More 340B Updates

In this episode, Greg and Rob catch up on more recent developments across the 340B community. They discuss recent Congressional activity where 340B has been a focus, a shift in court rulings related t...

4 Maj 47min

Ep 90 | 340B Updates

Ep 90 | 340B Updates

In this episode, Greg and Rob catch up on various developments happening in the 340B community. Topics discussed include the proliferation of manufacturer claim submission requirements, notable court ...

20 Apr 42min

Ep 89 | 340B Pricing Removal & GPO Prohibition Court Case Ruling

Ep 89 | 340B Pricing Removal & GPO Prohibition Court Case Ruling

In this episode, Greg and Rob discuss reports of 340B pricing removal from wholesaler accounts, which may be related to recent manufacturer claim submission requirement policies.  They also catch up o...

6 Apr 51min

Ep 88 | Hospital Child Sites – Recent Developments with CMS Provider-Based Rules and 340B Child Site Eligibility Timing

Ep 88 | Hospital Child Sites – Recent Developments with CMS Provider-Based Rules and 340B Child Site Eligibility Timing

In this episode, Greg and Rob are joined by returning guest, healthcare attorney Jeff Davis. They’ll be discussing the CMS provider-based rule changes coming out of the 2026 Consolidated Appropriation...

16 Mars 51min

Ep 87 | HRSA 340B Rebate Request For Information (RFI)

Ep 87 | HRSA 340B Rebate Request For Information (RFI)

In this episode, Greg and Rob are joined again by healthcare attorney Todd Nova to discuss the recent HRSA Request For Information (RFI) related to a potential future 340B rebate model pilot. They dis...

10 Mars 1h 9min

Ep 86 | Updates in 340B

Ep 86 | Updates in 340B

In this episode, Greg and Rob catch up on various looming deadlines for 340B providers.  That includes submitting responses to the HRSA 340B Rebate Request For Information (RFI), as well as submitting...

2 Mars 34min

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