Hospital & Healthsystem Association of Pennsylvania Comments on Centers for Medicare Medicaid Services's Information Collection Activities

WASHINGTON, Dec. 2 -- Jolene H. Calla, vice president of health care finance and insurance at the Hospital and Healthsystem Association of Pennsylvania, Harrisburg, has issued a public comment on the Centers for Medicare Medicaid Services's notice entitled "Agency Information Collection Activities; Proposals, Submissions, and Approvals". The comment was written on Nov. 27, 2019, and posted on Nov. 29, 2019:

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On behalf of The Hospital and Healthsystem Association of Pennsylvania (HAP), which represents 340B hospitals and health systems across the commonwealth, we appreciate the opportunity to comment on the Centers for Medicare & Medicaid Services (CMS) notice to survey all 340B hospitals to collect actual acquisition costs for specified covered outpatient drugs. However, we have significant concerns over the intent and design of the 340B hospital survey, and we respectfully request CMS to withdraw the survey.

As an association with 340B member hospitals, we have seen first-hand how hospitals are using the program savings to improve patient services and help their communities, as Congress intended. The 340B program has been critical in helping hospitals expand access to lifesaving prescription drugs and comprehensive health care services to low-income and uninsured individuals in communities across the country. Some examples of what hospitals are doing include: providing prescription medications at significantly reduced cost, or no cost at all; funding community wellness programs; providing healthy food initiatives; creating transportation partnerships to help people get to medical appointments; establishing satellite urgent care centers closer to where vulnerable patients live and operating an HIV clinic. We have significant concerns that the proposed survey will be used by CMS to continue its unlawful policies to reduce Medicare Part B payments to 340B hospitals, thus undermining the intent of the program and harming the ability to care for patients.

From an implementation perspective, this survey will significantly burden all 340B hospitals. These facilities operate on thin margins and already incur considerable costs to ensure they are compliant with program rules and requirements. These costs include dedicated staff time, as well as complex health information and inventory management systems. The survey would require considerable resources to gather the data requested, convert the data into the requested format, and complete everything within the time specified. In addition, to complete the survey, hospitals would need to access and assess proprietary drug prices from wholesalers. These hospitals purchase many of their 340B drugs through wholesaler purchasing arrangements. These arrangements are contractual agreements that often include strict non-disclosure conditions that restrict the sharing of any drug pricing information to any entity not party to the contract. These non-disclosure provisions would make it exceedingly difficult for 340B hospitals to share the data necessary to complete the survey in the time specified.

Thank you for your consideration of our comments. We strongly urge CMS to withdraw this survey and cease any further Medicare Part B payment policies that will undermine the intent of the 340B program.

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The notice can be viewed at: https://www.regulations.gov/document?D=CMS-2019-0142-0001

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