As shared last week, a bipartisan group of six Senators released a discussion draft of a bill (the SUSTAIN 340B Act) that is perceived as a positive step in the 340B debate. This draft bill contains many positive policies from a Community Health Center perspective. These include:
- It explicitly allows for contract pharmacies and prohibits drug makers from placing conditions on them.
- It bans 340B discrimination (“pick-pocketing”) by including the text of the PROTECT 340B bill verbatim.
- While it requires reporting on the use of 340B savings, it does not require covered entities to explicitly quantify those savings and allows savings to be used for both “healthcare services” and “health-related benefits.”
- It creates a national data clearinghouse to streamline the process of submitting claims-level data to various payers and explicitly bans requirements that pharmacies put 340B modifiers on claims.
On the other hand, the bill: requires all contract pharmacies to offer a “sliding fee scale” on drug costs to self-pay patients with incomes up to at least 200% FPL; imposes user fees on all covered entities (the amount is to be determined, but the bill suggests 0.01 percent of a covered entity’s average 340B savings over the past 5 years); and requires covered entities to repay manufacturers for duplicate discounts on Medicaid drugs. This two-page overview of the 340b reform bill focuses on issues of interest to Community Health Centers. Initial reactions from a range of 340B stakeholders have been positive. The Senators also released a Request for Information on three key areas – contract pharmacies, patient definition, and hospital child sites (including whether there should be limits on the number or location of contract pharmacy locations) with comments due by April 1.