HHS Revives 340B Rebate Program for US Hospitals: New Pilot Plan

• HHS plans to revive its rebate program for the 340B drug discount program, replacing upfront discounts with rebates for a subset of 340B drugs.
• The revised pilot program is set to start next year and will require hospitals to track and verify eligible claims.
• Lawyers advising US hospitals on the 340B program should watch for changes in reimbursement structures and potential compliance exposures.

The new plan aims to replace upfront discounts with rebates for a subset of 340B drugs, with the revised pilot program set to start next year.

The US Department of Health and Human Services (HHS) has announced plans to revive its rebate program for the 340B drug discount program. This move comes after a previous attempt by the Health Resources and Services Administration (HRSA), which is part of HHS, to implement a rebate model was blocked by courts due to procedural and legal issues. The new plan aims to replace upfront discounts with rebates for a subset of 340B drugs, with the revised pilot program set to start next year.

The 340B program allows hospitals to purchase outpatient drugs at significantly discounted prices, with the goal of using these savings to fund care for low-income and uninsured patients. However, under HRSA's new plan, drugmakers would pay providers back after their purchase rather than applying the discount at the point of sale. This shift in burden places a significant administrative task on hospitals, requiring them to track and verify eligible claims. The 340B program has been subject to various court challenges and regulatory changes over the years, with this latest development marking another attempt by HHS to refine its implementation.

The revival of the rebate program is significant for US hospitals participating in the 340B program. With the new plan, hospitals will need to adapt their revenue cycle management strategies to accommodate the change in reimbursement structures and potential compliance exposures related to tracking and verifying eligible claims. Lawyers advising these hospitals should be aware of the implications of this development and provide guidance on how to navigate the revised pilot program.

Lawyers advising US hospitals on the 340B program should watch for changes in reimbursement structures and potential compliance exposures related to tracking and verifying eligible claims under HRSA's revised pilot program.

Source: Original reporting via HHS Is Reviving Its 340B Rebate Push — And Providers Are None Too Pleased