Podcasts about 340b

In this episode of The Elephant in the Dome, Senator Chris Gildon hosts Senator Ron Muzzall the ranking Republican on the Senate Health and Long-Term Care Committee. They break down the complex 340B Drug Pricing Program—a federal initiative designed to help safety-net health clinics and hospitals acquire discounted prescription medication for low-income patients. They discuss […] The post Decoding 340B: The $81 Billion Drug Discount Program Explained | The Elephant in the Dome appeared first on Senate Republican Caucus.

In this episode, Greg and Rob recap highlights from this year's 340B Coalition Summer Conference in Washington, D.C. Comments or questions?  Email us at 340BUnscripted@spendmend.com

With hospitals facing increasing drug company restrictions on access to 340B savings and other challenges, some might be considering opening their own retail pharmacies to serve their patients. We speak with Sherstin Willyerd, director of pharmacy operations at Montgomery County Memorial Hospital in Iowa, to learn about how her hospital went this route and what others want to consider before doing the same. Buying Existing Pharmacies Can Be a Solution Willyerd said her hospital was able to purchase two independent pharmacies whose owners were retiring, providing an existing dispensing infrastructure and patient base from which to start. While the hospital still has some contract pharmacy partnerships, the in-house locations can serve patients and generate 340B savings that are less prone to drugmaker restrictions.A Retail Pharmacy Can Give Better Insight into Patient StrugglesOperating a retail pharmacy allowed Willyerd's hospital to see more clearly which patients were struggling with prescription drug costs and medication adherence and to provide more assistance to them. She noted that capturing more 340B savings makes it easier to pass along more discounts to patients who otherwise would not be able to afford their drugs.An Independent Insurance Plan Means Even More AssistanceMontgomery County Memorial Hospital also partnered with a pharmacy benefit manager (PBM) to create a primary and secondary prescription drug insurance plan that it offers to certain patients with low incomes and hospital employees. Willyerd noted that this plan can mean hundreds of dollars in savings per month for uninsured patients and those whose coverage comes with high cost sharing.Resources:HRSA Releases 340B Purchase Data for 2025

This episode of The Common Bridge is part of a special 21‑part series of interviews recorded with healthcare leaders from across Michigan during the 2026 Mackinac Policy Conference, in partnership with the Michigan Health and Hospital AssociationHealth care isn't just a line item anymore, it's the issue that keeps showing up in every hallway conversation. From the 2026 Mackinac Policy Conference, we sit down with senior health care executive Rob Casalou to get a clear-eyed view of what's pressuring hospitals in Michigan and across the country, and why the usual policy debates are starting to miss the real story. We compare what Rob sees across multiple states, from Michigan's purple-state gridlock to places like Iowa, where lawmakers are moving to penalize inappropriate insurance claim denials. We get specific about how “denials” can shift from legitimate documentation checks into a strategy that delays payment and inflates administrative costs. We also talk about why states as different as California and Idaho still end up wrestling with the same core topics: 340B drug pricing, site-neutral payments, hospital-based reimbursement, and the challenge of explaining any of it in plain English that connects to patients and communities. Then we zoom out to the bigger warning lights. Rob explains why HR1 and upcoming Medicaid revenue hits, combined with simultaneous changes to 340B and site-neutral rules, could put some hospitals at real risk. We also ask the question that keeps coming up in Michigan health care finance: if Medicare and Medicaid now represent the bulk of patients, how do we modernize those programs instead of constantly cutting around the edges while carrying the administrative costs of a fragmented system? If you care about Michigan health care policy, hospital sustainability, and what actually drives costs, listen through and share it with someone who still thinks this is just about “waste.” Subscribe, leave a review, and send us your take: what's the first fix you'd make?Support the showEngage the conversation on Substack at The Common Bridge!

This week in the Breakroom, Emily Cook, partner at McDermott Will & Schulte, and Katie Waldo join Maddie to break down 340B drug program proposals included in the recently released Medicare outpatient prospective payment system (OPPS) proposed rule for 2027, along with discussing prospects for 340B legislative proposals. Read more on the OPPS proposed rule here.

Read more from VPM News:  Frustration with McGuire drives both sides of 5th Congressional District primary  WATCH: Richmond Coliseum's days are officially numbered (YouTube)    Other links:  Cyclosporiasis Surveillance and Investigation (Virginia Department of Health)  Virginia needs more nurses. Training them requires more than adding classroom seats (WHRO)  Efforts to reform federal drug pricing program 340B continue with new report, proposed CMS rule (Virginia Mercury)  Documents: Former RPS facilities director was paid for six weeks after investigation due to rejected resignation (The Richmonder)  New Kent leaders poised to strike down proposed data center district (Richmond Times-Dispatch)*  ‘Oyez, oyez.' Supreme Court's last official crier is dead at 102. (The Washington Post)*  Virginia approves historical marker to the song that inspired a generation of rock stars (Cardinal News)  *This outlet uses a paywall.  Our award-winning work is made possible with your donations. Visit vpm.org/donate to support local journalism.

After years of lobbying and advocacy work by 340B covered entities, the Illinois state legislature approved major 340B legislation earlier this year that protects 340B contract pharmacy access and prohibits drugmaker claims on data demands. Thomas Yu, system director of ambulatory pharmacy services at Sinai Chicago, discusses the campaign that made this legislative victory possible and what covered entities in other states can learn from this success.Joint Events Showed Unity Among Safety-Net ProvidersYu says two “340B Saves Lives” days of action in Chicago helped drive support for the legislative effort. Under the leadership of an association representing community health centers, the events brought together covered entities, patients, lawmakers, and others to show a united front on the issue of protecting 340B.The Story of 340B Resonated With Lawmakers, Not Numbers AloneYu reiterates that statistics and data can be helpful in making the case for 340B but that the story of 340B is what can swing votes. Focusing on community impact and how covered entities use their savings to benefit patients was much more effective at imparting the importance of legislation to protect access to those savings.Illinois Legislation Was a Compromise The legislation package in Illinois contains 340B reporting requirements for covered entities in the state. Yu argues that this compromise was necessary as the contract pharmacy and claims data provisions would have been a “nonstarter” without that addition. However, because the numbers go to the state for a one-time report and because drugmakers also must report data, he says the overall legislative package still makes for a big win for covered entities and patients in the state.ResourcesIllinois Legislature Delivers Contract Pharmacy Victory for 340B HospitalsProposed Medicare Pay Cut for 340B Drugs Would Be Much Deeper Than 2018-2022 Reductions

In this episode, Greg and Rob are joined by Ted Slafsky and Will Newton of 340B Report. They recap major developments in the first half of 2026 that have impacted the 340B community. They'll discuss recent Congressional activity, including a newly introduced 340B Program reform bill (SECURE 340B Act), trends in federal administrative agency policies from HRSA and CMS, and the evolution of various manufacturer actions within the 340B Program. In the intro, they discuss recent HRSA audit finding trends and highlight key provisions in the CMS 2027 OPPS proposed rule, including anticipated Medicare Part B reimbursement reductions for 340B hospitals.    Use “SPENDMEND25” to get a 25% discount on a subscription to 340B Report: https://340breport.com/subscribe/ Going to the 340B Coalition Summer Meeting? Come see us at booth #418.

In this episode, Laura Dyrda, Vice President, Editor-in-Chief, Becker's Healthcare, discusses proposed CMS changes to the 340B program, site-neutral payment policies, and what they could mean for hospital and ASC finances. She also shares insights on shifting hospital expense trends, including rising drug and supply costs, and how health system leaders are adapting their strategies.

Kim Tzoumakas is the CEO of VytlOne, the nation's only independent, fully integrated total pharmacy solutions partner — the century-old company formerly known as Maxor, which she rebranded and merged with ProxsysRx in a fast-moving transformation after taking the helm in January 2025. VytlOne partners with mission-driven hospitals and health systems, combining pharmacy operations, 340B management, specialty pharmacy, pharmacy benefit management, and patient affordability solutions to help nonprofit providers unlock revenue and reinvest in their communities — work that generated $1.4 billion for its pharmacy partners in a single year. Its newest bet is VytlAIQ, an end-to-end intelligence platform built ground-up (not grafted onto a legacy system) that connects clinical, pharmacy, payer, and financial data into one real-time platform, surfacing next-best actions and checking every 340B claim for eligibility and documentation so problems get caught before they cost providers money. Kim came to pharmacy the long way around — two decades as a healthcare attorney embedded in hospitals and health systems, then CEO of RAYUS Radiology and 21st Century Oncology. Her core conviction is that 340B isn't a loophole to be abused or a relic on its way out; it's critical infrastructure that lets nonprofit health systems reinvest in patient care, and the real failure is that the tools serving it stayed reactive, fragmented, and manual. VytlOne's bet is that AI belongs in pharmacy not to replace clinical judgment or wipe out teams, but as an intelligent partner that tears down the administrative barriers — prior auth, denied claims, missing documentation — standing between a patient and their medication. The test of success: a patient who simply feels their care move faster and never once thinks about the software behind it.We discuss:Why the first thing Kim checks in any business isn't the P&L — it's the boards, the ownership model, and financial stability that determine whether a CEO can actually win — and what twenty years as a healthcare attorney inside hospitals taught her to seeThe real story on 340B: why the "it's going away" prediction has been wrong for thirty years, why the program is now evolving faster and getting more complex, and the one scenario where hospitals genuinely are in the wrong — double-dipping on rebatesHow you build a product when the rules might change next quarter — launching VytlAIQ right as the courts threw out the 340B rebate model, and why VytlOne built it from the ground up with pharmacists at the table instead of stitching together what already existedWhy most health-system dashboards get built and then ignored — and what makes a platform a pharmacist and a CFO will actually act on: one centralized, real-time source feeding the EHR that tracks every claim all the way through to payment receivedWhat you can't afford to break when you rebrand and merge a hundred-year-old company fast — protecting the culture and the people who gave decades to the organization while still turning the cornerThe uncomfortable truth for a CFO who's been burned by vendors — why pharmacy teams reflexively say "we already do that," where the skepticism about third parties really comes from, and how to turn a ten-million-dollar opportunity into a win-win instead of a threatWhere the line sits between what AI should decide versus only suggest in pharmacy — why it should never make a clinical or licensed decision — and the legal risks Kim sees as tech players rush into healthcare without understanding the guardrails, patient risks, or regulatory historyWhat Kim learned mentoring veterans through the Pat Tillman Foundation about fear of failure and hard choices — and the five-years-out test for VytlAIQ: a patient in specialty or chronic care who simply feels faster access to their medication and never connects it back to the software—Brought to you by: Sage Growth Partners — Value-focused strategy and marketing for growth-driven healthcare organizations. — Where to find Jared: • X: https://x.com/jaredstaylor • LinkedIn: https://www.linkedin.com/in/jaredstaylor/

Halfway through 2026, one trend has become impossible to ignore: health systems are beginning to split into two very different camps. Some are playing defense—focused on reimbursement pressures, Medicaid shifts, workforce challenges, and tightening margins. Others are taking an opportunistic approach, using these same market forces to expand specialty pharmacy, strengthen infusion services, optimize 340B, and position pharmacy as a strategic growth engine. In this mid-year check-in, host Jim Jorgenson is joined by Alex Varkey, Vice President of Client Success, and Dave Hager, Senior Vice President of Client Success at Visante, to revisit Visante's Top 10 Forces Shaping Health System Pharmacy in 2026 and discuss what they're seeing across the country. The message is clear: organizations making bold, strategic decisions today are positioning themselves for long-term success. In today's market, victory favors the brave—and with the right strategy and the right partner, today's challenges can become tomorrow's competitive advantage.

Greg Doggett, Counsel, Powers Pyles Sutter & Verville PC, and Felicity Homsted, CEO, FQHC 340B Compliance, discuss the current legal and regulatory landscape of the 340B program. They cover the intersection of 340B with the Inflation Reduction Act, concerns about the Rebate Model, pharmaceutical manufacturer restrictions and data requirements for covered entities, AbbVie's patient definition lawsuit, state reporting requirements, and potential Congressional action.Watch this episode: https://www.youtube.com/watch?v=KsnP7hLbvekEssential Legal Updates, Now in AudioAHLA's popular Health Law Daily email newsletter is now a daily podcast, exclusively for AHLA Comprehensive members. Get all your health law news from the major media outlets on this podcast! To subscribe and add this private podcast feed to your podcast app, go to americanhealthlaw.org/dailypodcast.Stay At the Forefront of Health Legal EducationLearn more about AHLA and the educational resources available to the health law community at https://www.americanhealthlaw.org/. 

On this episode of the Empowering Plans podcast series, Attorneys Kelly Dempsey and Naga Vivekanandan discuss recent 340B litigation filed by three major hospital systems. They explain how the 340B program works and summarize the allegations in the lawsuit, as well as explore what these cases could mean for contract pharmacy arrangements and self-funded plans. 

In this episode, Greg and Rob are joined by returning guest, healthcare attorney Emily Cook. They discuss a recent court ruling (Premier v HHS) that vacated HRSA's 2013 GPO Prohibition policy notice that addresses compliance with inventory replenishment models, covering insights into the court's opinion, what it means in terms of potential process changes for covered entities, and compliance considerations given that GPO Prohibition is still a statutory requirement for hospital eligibility in the 340B Program. They'll also touch on thoughts related to the process of reporting 340B pricing access issues to HRSA based on manufacturer actions.   Premier v. HHS court opinion:  https://law.justia.com/cases/federal/district-courts/district-of-columbia/dcdce/1:2024cv03116/27447…   340B Price Unavailability – How to Report to HRSA:  340B Price Unavailability - How to Report to HRSA | HRSA

With scores of pending lawsuits involving drugmaker and covered entity challenges of how federal and state governments regulate 340B, the courts have become an important arena in the national 340B debate. 340B Health's Vice President of Legal and Policy Amanda Nagrotsky unpacks some of the cases and what they might mean for 340B's future.Courts Wrestle With Issues of Federal and State AuthorityDrug companies have filed about 80 lawsuits challenging state contract pharmacy protection laws. Nagrotsky says drugmakers are arguing these state laws conflict with federal oversight, but most courts so far have ruled that contract pharmacy protection laws fall within a state's ability to regulate drug distribution and delivery. A recent decision from a federal judge in Mississippi was a major win for covered entities because it completely dismissed a drugmaker's challenge to the state's law rather than just ruling on whether to pause enforcement of the law. AbbVie Challenges 340B Patient DefinitionDrugmaker AbbVie is suing the Health Resources & Services Administration (HRSA) directly, arguing that the definition of whom the agency considers a 340B-eligible patient is too broad. AbbVie's own, narrower patient definition would require drug companies to discount far fewer drugs and thus would limit hospital access to 340B savings significantly. The government is asking the court to dismiss the lawsuit on procedural grounds, and 340B Health along with two member hospitals are asking the court to allow them to intervene as defendants and provide additional arguments for why it should throw out the case.Uncertainty Remains Despite GPO, Child Site RulingsFederal district court decisions found that HRSA failed to explain why it adopted a 2013 policy barring certain 340B hospitals' use of group purchasing organizations (GPOs) to make initial purchases for their virtual inventory systems and a 1994 policy establishing registration prerequisites for new 340B hospital outpatient facilities. Although the government opted against appealing the ruling striking down the GPO policy, the underlying prohibition remains in effect, leaving hospitals in limbo as to how HRSA will interpret the law. The government has appealed the child site ruling, and a final decision on that case will have a major impact on how quickly hospitals can use 340B drugs at new child sites.

Grant funding can open doors, but it can't close the gaps that form when revenue walks out the back door. In this follow-up episode of the EisnerAmper Healthcare Podcast, host Tony Davis continues the conversation with Jane Clark and Peter Avellino, shifting focus from grants to the operational and financial strategies rural hospitals need to build long-term resilience. Peter shares how attribution models can reveal where patients are going after leaving a facility, and why that intelligence is a game-changer for rural providers whose patient populations are finite. The episode covers revenue cycle fundamentals (coding accuracy, timely billing, follow-up scheduling), 340B program eligibility, pharmacy benefit management optimization, and how AI-assisted tools are compressing the time between date of service and cash collected. Jane connects the dots between grant strategy and revenue cycle improvement, making the case that federal programs like the Rural Health Transformation Program are increasingly designed to fund transformational infrastructure, including billing systems, data platforms, and workforce stabilization, rather than fill operating gaps. She closes with a direct message for rural and tribal health leaders: stop treating financing, operations, and compliance as separate conversations. If your organization is navigating thin margins, workforce pressures, or the question of whether to convert to a rural emergency hospital model, this episode gives you a practical framework for thinking about what to do next.

In this episode of the Vital Health Podcast, host Duane Schulthess speaks with Bill Smith (Senior Fellow and Director, Life Sciences Initiative at The Pioneer Institute) to discuss how the 340B program has evolved from a safety net drug discount program into a major source of hospital revenue, what new research suggests about charity care and Medicaid access, and why transparency, hospital consolidation, and broader drug pricing policy are reshaping incentives across oncology and biopharma. Key Topics: 340B Origins: Medicaid best price, safety net intent, clinic and hospital eligibility. Hospital Arbitrage: Buy-low sell-high incentives, affluent satellite sites, oncology drug spreads. Charity Care: Lower reported charity care, Medicaid access concerns, variation across hospital systems. Transparency Reforms: State reporting laws, separate audited accounts, minimum charity care requirements. Policy Collisions: Inflation Reduction Act (IRA) price controls, Most-Favored-Nation (MFN) pressure, oncology consolidation, biopharma investment risks. Opinions expressed are those of the speakers. Recorded 6/5/26. The Vital Health Podcast is a production of Vital Transformation LLC © 2026.See omnystudio.com/listener for privacy information.

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 recent litigation might have on enforcement of this standard. 

Maureen Testoni, the stalwart president and CEO of the renowned 340B Health Program, will join the long-running Monitor Mondays todiscuss Eli Lilly's escalating demands for hospitals to submit in-house claims data as a condition of receiving 340B drug discounts. Who will blink first?Register now to reserve your participation.Broadcast segments will also include these instantly recognizable features:·      Monday Rounds: Ronald Hirsch, MD, vice president of R1 RCM, will be making his Monday Rounds. ·      The RAC Report: Healthcare attorney Knicole Emanuel, partner at the law firm of Nelson Mullins, will report the latest news about auditors. ·      Risky Business: Healthcare attorney David Glaser, shareholder in the law offices of Fredrikson & Byron, will join the broadcast with his trademark segment.·      Legislative Update: Folana Houston, legislative affairs analyst for Zelis, will report on current healthcare legislation.

The U.S. administration is keen to sign up more companies to drug pricing deals, and mandatory rules are on the way. But how will the midterm elections affect these and other healthcare policy issues? At RBC's Global Healthcare Conference, Hunter Hammond and Will Humphrey of Capstone's healthcare group offered insights on the direction of policy for the rest of the year and beyond. Key PointsMandatory Most Favored Nation pricing rules are likely to be contested in court.The FDA's initiatives to speed drug development are signals of its modernization intent.The U.S. is more likely to use incentives than sanctions to address mass in-licensing of Chinese innovation.The current program to extend access to GLP-1s could be a template for future breakthrough drugs.Democrat gains in the midterm elections would likely limit further hospital cuts.Introductions [00:08]Host Joe Coletti introduces highlights from the U.S. Healthcare Policy Panel at RBC's Global Healthcare Conference, featuring Hunter Hammond and Will Humphrey of Capstone's Healthcare Group. Midterm campaigning [00:40]In the run-up to the midterms, the U.S. administration will aim to focus on messaging about popular policies, such as cutting waste and fraud in Medicare and Medicaid.FDA changes [01:41]After turmoil in the FDA, new leadership is designed to promote stability. Recent moves to speed drug approvals are likely to continue and offer an important signal about FDA modernization. Chinese innovation [04:31]The administration may be uncomfortable with U.S. in-licensing of Chinese technologies, but it is more likely to respond with incentives than any attempt to block the practice.Drug pricing [06:17]Most Favored Nation mandatory pricing models have yet to be finalized and are likely to be challenged in court. Democrats will not support codification of MFN.Democrat priorities [08:08]Democratic gains in the midterms would have the effect of protecting hospitals from further cuts. Reform of 340B is unlikely, however.

Minnesota lawmakers failed to add protections to an obscure discount drug program this year, amid complaints from the pharmaceutical industry that some large hospitals abuse the so called 340B program.Republican-endorsed governor candidate Kendall Qualls says the campaign focus this year shouldn't be on President Donald Trump. Qualls is one of several candidates in a GOP primary race to determine the party nominee.An ICE detainee from Burnsville with serious health problems was released Wednesday. Andrea Pedro-Francisco is a twenty three year old asylum seeker who has lived in Burnsville with her family since 2019. She was detained by ICE in February and sent to Texas just before a planned surgery to remove an ovarian cyst.

What does the future hold for the 340B Drug Pricing Program? In this episode, ASHP Executive Vice President and CEO Sam Calabrese sits down with ASHP Chief Advocacy Officer and Vice President of Government Relations Tom Kraus to discuss what health-system pharmacy professionals are hearing on the ground, the real-world value the 340B program brings to patients and communities, and ASHP's latest efforts to safeguard the program. Tune in for an inside look at the challenges, opportunities, and advocacy shaping the road ahead. The information presented during the podcast reflects solely the opinions of the presenter. The information and materials are not, and are not intended as, a comprehensive source of drug information on this topic. The contents of the podcast have not been reviewed by ASHP, and should neither be interpreted as the official policies of ASHP, nor an endorsement of any product(s), nor should they be considered as a substitute for the professional judgment of the pharmacist or physician.

In Episode 136 of DC EKG, Joe Grogan hosts Tom Barker, a top drug-pricing attorney at Foley Hoag and former acting general counsel of Health and Human Services (HHS) under the Bush administration. Tom helped implement Medicare Part D and now advises drugmakers and policymakers on complex pricing issues. The episode traces 20 years of policy: what went right with Part D, what the Inflation Reduction Act (IRA) did, and what effective policy should look like.Tom explains that Part D's success rested on three pillars: private plans only, limited government control over benefit design, and a non-interference clause barring the government from intervening in negotiations among plans, pharmacies, and manufacturers. Competition worked and premiums stayed low, until the government asserted more control and weakened those pillars. The IRA, he argues, was a 16-year Democratic effort to repeal non-interference, creating price controls disguised as negotiations.The Trump administration has taken a different tack, focusing not on the IRA but on MFN and Globe Guard models pegged to other developed countries. Tom also breaks down the 340B program, now the country's second-largest expenditure program, and the fight between manufacturers and covered entities over contract pharmacies.His prescription is simple: let competition work. Speed FDA approval of generics and biosimilars, and trust the marketplace over price controls. He points to hepatitis C, where prices fell sharply once competition entered.In This ConversationThe three pillars that made Part D successful for 20 yearsHow non-interference kept government from setting drug pricesThe IRA as a 16-year Democratic push to repeal non-interferenceWhy Tom calls the IRA price controls disguised as negotiationsThe Trump administration's focus on MFN and Globe Guard pricing340B and the battle between manufacturers and covered entitiesThe Chevron repeal's impact on drug pricing lawHRSA's proposed rebate model and ongoing 340B litigationWhy effective policy means competition, not controlsTom's work helping North Korean defectors and refugeesKey Timestamps1:51 Tom's background at HHS and CMS2:30 The three pillars of Part D's success5:10 Why Democrats wanted to repeal non-interference5:55 Ted Kennedy's compromise and bipartisan votes11:38 The IRA as a 16-year repeal attempt12:03 What the IRA changed in Part D15:02 IRA negotiations vs. real negotiations16:25 How the excise tax makes it no real negotiation21:32 Trump's focus on MFN and Globe Guard25:37 340B's history back to 199128:45 340B as the second-biggest expenditure program29:30 Manufacturer vs. covered-entity acrimony33:18 The Chevron repeal's impact on pricing34:54 HRSA's rebate model, the next step on 340B35:40 The lawsuit over "patient" in 340B38:18 Tom's advice: let competition work39:30 Hepatitis C: competition drives prices down40:34 Competition for gene therapies and CRISPR41:36 Tom's work for North Korean defectors44:49 Sponsoring Free North Korea RadioMedicare Part D, drug pricing policy, Inflation Reduction Act, non-interference clause, 340B program, MFN pricing, Globe Guard pricing, pharmacy benefit managers, covered entities, contract pharmacies, biosimilars, generics, federal drug pricing, government price controls, Tom BarkerAbout the GuestTom Barker is a partner at Foley Hoag in Washington, DC, and one of the country's top drug pricing attorneys. He served as acting general counsel of HHS and chief legal officer at CMS under the Bush administration, where he helped implement Part D from its inception. He is now a go-to expert on drug pricing, and helps North Korean defectors navigate US immigration law.Podcast: DC EKG with Joe Grogan Episode: 136 Guest: Tom Barker Sponsor: Survivors for Solutions - https://survivorsforsolutions.org Executive Producer: John "CZ" Czwartacki, DC EKG Podcast Producer: Stay on Course Studios - https://www.stayoncourse.studio

Hospitals already have felt some of the effects of the Inflation Reduction Act on 340B savings, but with the IRA set to expand to more drugs in 2027, hospitals also are starting to project how it might affect their bottom lines next year. 340B Vice President of Pharmacy Services and Education Steven Miller joins us to explain how hospitals can be making those projections now.The IRA Will Expand to Another 15 DrugsNext year, an additional 15 drugs will be subject to Medicare price caps under Medicare Part D on top of the 10 drugs that saw caps this year. Steve says this will cut into 340B savings and overall margins even more — with some 340B discounts possibly dropping to their statutory minimums. These reductions also will translate to commercial and cash-pay dispenses, changing the overall financial outlook for hospitals.Hospitals Cannot Rely on Current 340B Savings Levels for 2027Steve says the 2027 changes are key for future budgeting. If hospitals do not adjust how they are budgeting for 340B drugs subject to Medicare price caps, they are likely to be short on their budget projections. He strongly recommends 340B teams have important conversations with finance teams now about how the IRA will affect their hospital or health system next year.Hospitals Can Be Planning NowFor the rest of 2026, Steve recommends hospitals monitor list pricing and 340B ceiling pricing regularly and to increase monitoring of purchases overall, given how drugmaker pricing behavior affects future 340B prices and savings. As the IRA continues to broaden over the next several years, including to Medicare Part B dispenses, he also recommends hospitals consider securing funding or support from other areas for any 340B-funded services that might see negative IRA impacts.Resources:Prepare Your Leadership for 340B Changes From 2027 Medicare Drug Price Caps

Dr. Emily Holt returns to the podcast one year after opening Poppy Direct Care in New Orleans, and the landscape around her has changed dramatically.When Maryal last spoke with Dr. Holt, Poppy was just months old and DPC Summit attendees were touring her 100-year-old clinic house. A year later, her panel has more than doubled, she's about to opt out of Medicare, and she's a named plaintiff in a lawsuit against Louisiana's Attorney General over the state's classification of mifepristone and misoprostol as controlled substances.This conversation goes deep on what it actually looks like to build a mission-driven DPC in a state that keeps making reproductive healthcare harder to deliver.In this episode, Dr. Holt shares:How word of mouth (plus authentic Instagram and TikTok) became her entire growth engineWhy her practice is intentionally slow-rolling, and how she and her husband decided what "enough" looks likeThe patient shift happening as 2026 insurance premiums skyrocket and Medicaid eligibility stays restrictiveWhat it means that every Planned Parenthood in Louisiana has closed, and how Poppy is trying to fill the gapHer free Tuesday night clinic for birth control and rapid STI testing, and the new Louisiana Health Department rules designed to shut clinics like hers outWhy being a Baija Charitable Alliance affiliate mattered for 340B pricing, and what the new program changes mean for small DPCs serving uninsured patientsThe reality of trying to provide IUDs for emergency contraception when no nearby pharmacy stocks themHow being her own boss let her join a lawsuit that employed physicians told her they couldn't touchWhat Reproductive Health Access Project (RHAP) offers cliniciansHer vision for turning Poppy into a training ground for med students and residents shut out of reproductive health experience in-stateMemorable moments:"If you can't stand for something, you will fall for anything."The state offering one dollar per patient to reimburse rapid STI testing supplies that cost forty-five dollarsThree generations of plumbers getting Poppy ready for Monday patientsWhy patients tell her, unprompted, that they trust her to trust themResources mentioned:Dr. Emily Holt's GoFundMe for an autoclave at Poppy Direct CareTake Me Home Program — free at-home HIV, hepatitis C, and syphilis testing mailed nationwideReproductive Health Access Project (RHAP)Dr. Byron Jasper and Byja Charitable AllianceAAFP DPC Member Interest GroupThe July My DPC Story live event in New Orleans, pairing Dr. Esther Katibi's nonprofit with Dr. Holt's work at PoppyDr. Holt's advice for DPC physicians thinking about reproductive health access in their own communities: find the helpers, get connected to local groups already doing the work, and don't wait until you have everything figured out to start.Learn more about VIVID VAULT HEALTH SOLUTIONS TODAY! Find a My DPC Story Event near you! State Summits in CA, IL, a My DPC Story LIVE event and the DPC Women's Summit are all coming! Learn more at mydpcstory.com/upcoming-events! The DPC Directory: If you're a DPC doctor, you'll find resources to grow your practice! If you serve the DPC world, grab a FREE listing today and get discovered by doctors who need your services.

On this episode of This Week in Pharmacy, we examine two major forces reshaping the profession: the unfinished business of pharmacist provider status and the legal landscape around direct-to-consumer pharmaceutical distribution. In part one, Erik Abel, PharmD, MBA, discusses his May 2026 analysis, “So Pharmacists Want to Be a Provider: Where the Profession Lost Its Way and Perhaps a Path to Get Back.” Abel argues that pharmacy's provider-status challenge is not a lack of clinical evidence, but a lack of operational infrastructure: credentialing, payer contracting, revenue cycle management, interoperability, and scalable business models. In part two, Darshan Kulkarni, PharmD, Esq., joins the show to discuss direct-to-consumer pharmaceutical distribution, legal risk, regulatory scrutiny, telehealth-linked prescribing, manufacturer strategy, and what pharmacists need to understand as drug distribution moves closer to the patient. This week in pharmacy news, Pittsburgh-area pharmacies continue to face uneven access to Adderall and other ADHD medications, years after the FDA first identified shortages in 2022. Patients are still calling multiple pharmacies, switching medications, rationing doses, or going without treatment as availability varies by dosage, formulation, manufacturer, and wholesaler. Pharmacists are also using medication therapy management to protect older adults from preventable medication-related harm. MTM reviews can identify risky prescriptions and OTC products, including diphenhydramine, duplicate therapies, drug interactions, and long-term proton pump inhibitor use that may need reassessment. In 340B news, CVS Health is facing federal lawsuits from major health systems alleging CVS Specialty and WellPartner improperly retained approximately $250 million in savings that should have gone back to covered entities. The litigation adds pressure to debates over PBM integration, contract pharmacy arrangements, and 340B transparency. On Capitol Hill, lawmakers are pressing the Department of Defense to commit to annual audits of the TRICARE pharmacy contract as concerns continue around PBM conflicts of interest, reimbursement practices, network adequacy, and access for independent and community pharmacies.

Mark Denzler breaks down growing concerns over the federal 340B drug pricing program, arguing that a policy originally designed to help low-income and rural patients has expanded far beyond its intent and is now driving up employer and taxpayer health care costs. He explains that hospitals purchase outpatient drugs at steep discounts but often bill insurers at full price, with the spread increasingly concentrated in large, wealthy hospital systems rather than safety-net providers. The discussion highlights claims that employers are absorbing hundreds of millions in added costs annually through higher premiums and deductibles, with similar effects reported across multiple states, including Missouri. The segment closes with broader frustration over health care billing practices, including how insurance-driven pricing, overtesting, and system incentives may be contributing to rising premiums for consumers across the board. Hashtags: #HealthcareCosts #Insurance #340BProgram #Hospitals #DrugPricing #EmployerCosts #IllinoisPolitics #MissouriNews #HealthPolicy #PremiumIncreases

The show opens with Hour 1 focused on culture war and political flashpoints, including debate over women's sports, conservative activism, and a heated discussion about Illinois politics and the Chicago Bears potentially leaving the state over taxes and economic decline, alongside consumer issues like AI-driven social media manipulation and rising skepticism toward government policy ideas like tax restructuring. Hour 2 shifts into consumer and local policy concerns, including Missouri Lottery privacy debates, frustration over retail rounding practices, Waymo's regulatory hurdles, rising St. Louis water rates tied to infrastructure funding and Rams settlement money, and a major healthcare cost discussion with Ross Marchand centered on insurance premiums and liability-driven price inflation, before closing with viral national stories and pop culture commentary. Hour 3 broadens into global and economic pressure points, featuring analysis of Iran strategy and geopolitical risk from Jim Talent, followed by a deep dive into healthcare pricing distortions from Mark Densler regarding the 340B drug program and its impact on employers and taxpayers, and ending with consumer behavior debates over cash usage, penny rounding changes, tipping, and financial control concerns. Hour 4 returns to major political and cultural issues, opening with a St. Louis funding fight over water rates and Rams money, then moving to Shannon Bream previewing major Supreme Court cases and legal controversies, Griff Jenkins reporting from the Indy 500 with a Memorial Day tribute to fallen service members, and Byron Donalds closing with a sharp critique of Democratic foreign policy toward Cuba and broader accusations of political hypocrisy. Hashtags: #StLouis #SupremeCourt #Iran #HealthcareCosts #Cuba #Indy500 #MemorialDay #ChicagoBears #IllinoisPolitics #WaterRates #RamsMoney #USPolitics #CultureWar #Economy #TaxPolicy

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 reform. Questions or comments? Email us at 340BUnscripted@spendmend.com!

Drug companies often initiate good-faith inquiries of covered entities (CEs) to learn more about certain purchase patterns or volumes, but how should hospitals navigate these requests? Bibi Wishart, director of pharmacy at Atrium Health, describes what she's learned being on the receiving end of these inquiries.Why Do Good-Faith Inquiries Happen?Bibi says the recent rise in good-faith inquiries is tied in part to drug companies gaining access to more varied data sources and expressing a goal of ensuring the information they collect is in line with what they are expecting. She says a variety of different factors could trigger this type of inquiry, including new providers purchasing certain drugs, concerns about duplicate discounts, or confusion around whether a drug is being used in an inpatient or outpatient setting. Hospitals are very complicated, so responding to an inquiry often can be more about educating drug companies about how hospitals dispense drugs.How Should a Hospital Respond?If her hospital receives a communication from a drug company through its authorized official and primary contact, Bibi says she prefers to respond within one or two business days just to confirm she has received the inquiry. She says that while it may take several days or weeks to respond with the requested data, that initial response establishes a cooperative tone and ultimately might prevent escalation to a formal audit process. That also gives the 340B team time to pull in the correct departments and hospital data to provide a full response.Ways To Prevent the Need for InquiriesDue to the sheer complexity of dispensing drugs — including reconciling data feeds from third-party administrators, vendors, and electronic medical records — regular internal audits are one of the best ways to identify discrepancies before drugmakers launch inquiries about them. Bibi recommends using internal auditing to catch these issues and having clear procedures in place for how to resolve any potential errors.

Send us Fan MailWe sit down with former Congressman and psychologist Tim Murphy to show how mental health laws really get made and why “good ideas” often get changed or stripped before they ever help families. We dig into Medicaid rules, treatment access, psychosis risks, and the hard truth that silence is how broken systems stay in place. • the real path of a bill from idea to compromise to final vote • why mental health policy creates intense conflict between groups • assisted outpatient treatment as an alternative to repeated hospitalization • how “gravely disabled” standards shape who can get care • Medicaid payment rules that discourage psychiatric beds and longer stays • why Congressional Budget Office scoring can derail reforms • what happens when severe mental illness is handled in jails • solitary confinement as a driver of worsening symptoms and suicide risk • high potency marijuana and the rising risk of psychosis • the estimated $340B to $380B annual cost of schizophrenia • families left holding the system together without guidance • HIPAA and confidentiality blocking parents from sharing critical history • why large organizations lose focus and stall action • how autism and schizophrenia advocacy can find common ground • practical steps to educate legislators through emails letters and visits If you know someone who has a story to you, tell them to contact us at why notme.world. One last time, spread the word about why not me. INTRO/OUTRO Music: T. WildMantor Music BMIhttps://tonymantor.comhttps://Facebook.com/tonymantorhttps://instagram.com/tonymantorhttps://twitter.com/tonymantorhttps://youtube.com/tonymantormusicintro/outro music bed written by T. WildWhy Not Me the World music published by Mantor Music (BMI)

We're back for part two with Elizabeth Kutter, vice president and deputy chief counsel at the Michigan Health & Hospital Association, joins us on today's episode of Rural Health Today. Healthcare expenses continue to outpace the cost of living, creating more financial strain for hardworking families across the US. Elizabeth is here to provide her insight as an advocate for healthcare funding in Michigan's state government. We'll talk about Medicaid cuts, state budget priorities, and of course, what it all has to do with rural health.  Follow Rural Health Today on social media! ⁠https://x.com/RuralHealthPod⁠ ⁠https://www.youtube.com/@ruralhealthtoday7665⁠  Follow Hillsdale Hospital on social media! ⁠https://www.facebook.com/hillsdalehospital/⁠ ⁠https://www.twitter.com/hillsdalehosp/⁠ ⁠https://www.linkedin.com/company/hillsdale-community-health-center/⁠ ⁠https://www.instagram.com/hillsdalehospital/⁠  Follow our guest! ⁠https://www.linkedin.com/in/elizabeth-kutter-93b02740/⁠ ⁠https://www.linkedin.com/company/michiganhospitals/posts/?feedView=all⁠ ⁠https://www.facebook.com/MichiganHospitals

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 to state contract pharmacy laws, and they catch up on recent litigation over 340B child site eligibility timing, GPO Prohibition policies, and patient definition. They round out the discussion by recapping developments with manufacturer contract pharmacy restrictions and claim-level data submission policies. Email us questions at 340BUnscripted@spendmend.com

Rural Health News is a weekly segment of Rural Health Today, a podcast by Hillsdale Hospital. News sources for this episode: Gary L. Roth, DO, “Fact Check: Drug Pricing Savings Are the Lifeline to Community Healthcare Services,” April 30, 2026, https://www.mha.org/newsroom/fact-check-drug-pricing-savings-are-the-lifeline-to-community-healthcare-services/, Michigan Health and Hospital Association.  American Hospital Association, “AHA urges HRSA to act as Eli Lilly threatens 340B discounts over claims data submission policy,” April 27, 2026, https://www.aha.org/news/headline/2026-04-27-aha-urges-hrsa-act-eli-lilly-threatens-340b-discounts-over-claims-data-submission-policy.  American Hospital Association, “Washington Post publishes AHA letter in response to anti-340B editorial,” April 22, 2025, https://www.aha.org/news/headline/2026-04-22-washington-post-publishes-aha-letter-response-anti-340b-editorial. Jennifer Wessel, JD, MPH, “Commercial Insurers' Payments to Hospitals Closer to Medicare Rates in Arkansas Than in Any Other State,” May 15, 2024, https://achi.net/newsroom/commercial-insurers-payments-to-hospitals-closer-to-medicare-rates-in-arkansas-than-in-any-other-state/, Arkansas Center for Health Improvement. Tess Vrbin, “Low reimbursement rates force Arkansas hospitals to scale back services,” April 21, 2026, https://arkansasadvocate.com/2026/04/21/low-reimbursement-rates-force-arkansas-hospitals-to-scale-back-services/, Arkansas Advocate. Rural Health Today is a production of Hillsdale Hospital in Hillsdale, Michigan and a member of the Health Podcast Network. Our host is JJ Hodshire, our producer is Kyrsten Newlon, and our audio engineer is Kenji Ulmer. Special thanks to our special guests for sharing their expertise on the show, and also to the Hillsdale Hospital marketing team. If you want to submit a question for us to answer on the podcast or learn more about Rural Health Today, visit ruralhealthtoday.com.

Congratulations to Logan Eury and his new wife Emily, got married today, May 1, 2026!  This C.O. Bigelow Collab Introduces the 188-Year-Old Pharmacy to a New Generation Abbode is taking over the Carolyn Bessette-Kennedy-approved shop for a month-long pop-up. https://fashionista.com/2026/05/co-bigelow-abbode-pop-up-carolyn-bessette-impact  The article highlights how a pop-up and renewed interest in C.O. Bigelow has been fueled by the cultural resurgence of Carolyn Bessette-Kennedy's minimalist style, amplified by media and social buzz. This renewed attention has driven significant foot traffic and sales, showing how storytelling, nostalgia, and “quiet luxury” aesthetics can translate into real retail impact.   Q&A: Mayo Clinic leaders share strategies for managing high-cost drugs without breaking the bank | Asembia AXS26 Summit https://www.managedhealthcareexecutive.com/view/q-a-mayo-clinic-leaders-share-strategies-for-managing-high-cost-drugs-without-breaking-the-bank-asembia-axs26-summit Mayo Clinic leaders emphasize that managing high-cost drugs requires clear definitions, structured formulary review processes, and multidisciplinary collaboration to balance cost, access, and clinical value. They highlight the importance of evaluating safety, efficacy, financial impact, and site-of-care decisions together, while noting that non-340B systems face increasing pressure from rising costs and reimbursement constraints. Ultimately, success depends on stronger alignment between health systems, manufacturers, and payers to sustain access without compromising quality of care.  Where Gross-to-net Pressure Actually Lives After Launch Today's guest post comes from Cindy Baksh, Chief Product Officer at ConnectiveRx. https://www.drugchannels.net/2026/05/where-gross-to-net-pressure-actually.html The article explains that “gross-to-net pressure” isn't driven by a single factor, but by a combination of rebates, discounts, fees, and policy changes that continue to reshape how drug pricing actually works behind the scenes. As the industry shifts toward a “net pricing” model, traditional rebate-driven strategies are weakening, forcing manufacturers, PBMs, and pharmacies to rethink how value and profits are generated. Today's featured guest is Dr. Ndidiamaka Okpareke PharmD for Congress Dr. Ndidiamaka “Didi” Okpareke, PharmD, is a pharmacist, entrepreneur, and political candidate running for Congress in New Mexico's 1st Congressional District. A first-generation Nigerian-American, she built her career in healthcare after graduating from the University of New Mexico College of Pharmacy and went on to found and lead a successful compounding pharmacy serving her community.  Motivated by nearly two decades of patient care experience, Okpareke entered the political arena to address challenges such as healthcare access, rising costs, and the shortage of providers in New Mexico. Running as a Republican, she emphasizes strengthening healthcare systems, supporting economic growth, and preserving opportunity for future generations, positioning herself as a community-focused leader bringing frontline healthcare insight into public policy.  This special episode highlights how TJM Labs is redefining pharmacy operations through AI-driven automation, bringing together insights from industry leaders Bhavesh Patel, PharmD—CEO of Carepoint Pharmacy—and Jonathan Adly, PharmD, MBA—CEO of TJM Labs. At the center of the conversation is how modern pharmacies are facing rising prescription volumes, staffing constraints, and increasing operational complexity, and why traditional manual workflows can no longer keep pace. TJM Labs addresses this challenge by deploying AI-powered “digital workers” that automate tasks like prescription intake, data entry, and patient communication—allowing pharmacy teams to shift their focus back to patient care and clinical decision-making.  Through the lens of both operator and innovator, the discussion explores how AI is not replacing pharmacy professionals, but augmenting them—reducing burnout, improving accuracy, and enabling scalable growth. With automation handling up to the majority of repetitive workload and delivering measurable ROI, TJM Labs represents a new model where technology and pharmacy expertise work together to create more efficient, patient-centered operations. 

Elizabeth Kutter, vice president and deputy chief counsel at the Michigan Health & Hospital Association, joins us on today's episode of Rural Health Today. Healthcare expenses continue to outpace the cost of living, creating more financial strain for hardworking families across the US. Elizabeth is here to provide her insight as an advocate for healthcare funding in Michigan's state government. We'll talk about Medicaid cuts, state budget priorities, and of course, what it all has to do with rural health.  Follow Rural Health Today on social media! https://x.com/RuralHealthPod https://www.youtube.com/@ruralhealthtoday7665  Follow Hillsdale Hospital on social media! https://www.facebook.com/hillsdalehospital/ https://www.twitter.com/hillsdalehosp/ https://www.linkedin.com/company/hillsdale-community-health-center/ https://www.instagram.com/hillsdalehospital/  Follow our guest! https://www.linkedin.com/in/elizabeth-kutter-93b02740/ https://www.linkedin.com/company/michiganhospitals/posts/?feedView=all https://www.facebook.com/MichiganHospitals

Send us Fan MailMFP is officially here and for many pharmacies, the biggest challenge isn't the pricing, it's understanding how the money actually flows and making sure you're getting paid correctly.In this episode of The Bottom Line Pharmacy Podcast, Austin Murray sits down with Katheryne Richardson, Chief Strategy Officer at Second Sight Solutions (Beacon Channel Management) to break down the mechanics of Maximum Fair Price (MFP), how reconciliation works, and what pharmacies need to be watching closely in this evolving reimbursement landscape.They cover:What MFP is and why it's impacting pharmacies for the first time in 2026How the Beacon platform provides visibility into the MFP rebate lifecycleCommon misconceptions around payment timing and reconciliationThe critical differences between MFP rebates and 340B claimsPractical tips for resolving payment discrepancies and staying proactiveAnd more!More About Beacon Channel Management:Beacon Channel Management is and innovative technology that reimagines how drug discount data is exchanged, establishing new connections and improving transparency for drug manufacturers and 65,000 of their customers.Stay connected with Beacon Channel Management:Beacon WebsiteCheck out all our social media:FacebookTwitterLinkedInScotty Sykes – CPA, CFP LinkedInScotty Sykes – CPA, CFP Twitter More resources on this topic:Beacon Rebate Model: https://cm.beaconchannelmanagement.com/Podcast - MDPNP's Impact on 340B: https://youtu.be/rJWNA7hHThY

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 rulings and 340B-related lawsuits, and reactions to Congressional hearings that featured testimony related to 340B Program reform considerations. Got questions?  Email us at 340BUnscripted@spendmend.com! 

In this episode, Todd Roberts, CFO, Cheshire Medical Center, shares how he is tackling 340B challenges, driving operational excellence, and strengthening financial resilience through system collaboration. He also discusses evolving CFO leadership, workforce pressures, and the shift toward value-based care models.

340B Insight wants to make our podcast the best it can be. To help us succeed, we'd like to hear your thoughts. Please take just a few minutes to complete our listener survey, and we will enter you in a drawing to win a $100 gift card! To participate, please go to 340bpodcast.org/survey.340B lately has had a news cycle that seems to change by the hour, and 340B Health President and CEO Maureen Testoni joins us to break down some of the biggest news happening in Washington, D.C., and in courthouses around the country.HRSA Seeks Feedback on Reviving Rebates After courts halted the rebate pilot that was set to go into effect in January, Maureen notes that the Health Resources & Services Administration is seeking more information on a possible revival of its rebate plans. Hospitals are responding with their objections, as are lawmakers on Capitol Hill. Nearly 100 members of the House of Representatives wrote a letter to the committee in charge of funding HRSA urging it to block federal spending for any HRSA rebate model.Huge Rulings on the GPO Prohibition, Child Site RegistrationThe past several months have seen big 340B rulings from federal courts. One decision vacated HRSA guidance that had blocked certain 340B hospitals' use of GPOs for their initial drug inventory, finding that HRSA failed to properly explain the reasons for that restriction. The other decision found that HRSA similarly failed to explain a rationale for restricting 340B eligibility for child sites for up to 23 months after the sites come online. Maureen notes that HRSA could appeal the rulings or seek to issue new guidance.Federal Government Weighs in on State Contract Pharmacy LawsuitsFor the first time, the federal government has filed briefs in support of drug companies in several lawsuits over state contract pharmacy protection laws. In these briefs, Maureen says the government effectively is telling judges it does not believe states have the right to protect contract pharmacy because federal 340B law preempts such actions. With the federal government weighing in on the matter and a recent split among appeals courts over the issue of preemption, it is possible this issue might be appealed at some point to the U.S. Supreme Court.ResourcesUse Our Letter Template Today To Oppose Development of a New 340B Rebate ProgramNearly 100 Members of Congress Urge Funding Block for 340B Rebate ModelPlease Help Advocate for Enforcement Actions Against Drugmakers' In-House Claims Data DemandsFederal Court Vacates HRSA's 2013 GPO Prohibition PolicyFederal Court Decides HRSA Child Site Eligibility Restrictions Are UnlawfulFederal Government Backs Drug Companies in Litigation Over State Contract Pharmacy LawsAppeals Court Blocks West Virginia 340B Contract Pharmacy Law, Creating Potential Split with Other Circuits340B Health Impact Profile Guidebook and Template

Crain's reporter Rachel Herzog talks with host Amy Guth about local commercial real estate news, including the Candy Hall of Fame coming the Mag Mile. Plus: Mayor Johnson reshuffles key safety and transportation posts amid staff churn, Madigan's high-powered appeals team urges 7th Circuit to overturn speaker's conviction, AbbVie suing feds over 340B provider audits and Quigley bill aims to speed up pipeline of new homes. Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.

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 on some developments in state-level contract pharmacy laws, including Washington's newly passed state law that incorporates contract pharmacy provisions, as well as reporting requirements for both providers and manufacturers. As a bonus, Nick Gnadt joins at the end to share an update on a recent court ruling (Premier v HHS) in which a judge vacated the 2013 HRSA GPO Prohibition Policy Notice. Premier, Inc. v HRSA DC District Court Ruling:  https://cases.justia.com/federal/district-courts/district-of-columbia/dcdce/1:2024cv03116/274475/23… Questions for us? Email us at 340BUnscripted@spendmend.com

Rob Howe has lived with type 1 diabetes for 21 years. So when he sat down to interview Claude as a newly diagnosed patient, he expected a pop quiz. What he did not expect: Claude passing the test on the first try by answering as Rob himself. Because Claude thought it been hosting this show all along. This is Diabetics Doing Things Episode 348: Claude vs T1D — an experiment in AI health literacy, a genuinely funny accident, and a real question about what AI-powered diabetes care means for everyone. Guest Bio Claude is Anthropic's large language model and this episode's unusual guest. Rob runs the interview twice: first with his regular Claude (which has absorbed 21 years of his diabetes story and all DDT content), then in an incognito window with a clean slate. The contrast is the episode. Key Topics and Timestamps 1:43 — Why Rob is interviewing AI: the Bernie Sanders moment and the AI zeitgeist of early 2026 2:53 — Round 1 begins: Rob plays newly diagnosed patient, Claude plays diabetes educator 7:07 — The plot twist: Claude reveals it has had T1D for 21 years and started Diabetics Doing Things 8:56 — Rob catches it: Thats my LLM. Resets to incognito mode. 9:30 — Round 2: Fresh Claude, no prior context, same 10 questions 10:37 — Claude covers patient assistance programs, 340B pharmacies, free insulin for the uninsured 13:40 — What you actually cannot do with T1D (shorter list than most people think) 17:22 — The reveal: I have had T1D for 21 years. I think you passed. 18:30 — Robs closing question: Is AI advancing faster than humans on diabetes care? Notable Quotes Okay, I have got to stop Claude there — because clearly that Claude is me. — Rob Howe I started Diabetics Doing Things because I realized there was not enough honest conversation about living with type one — the medical stuff, but the real life stuff, the mental load, the wins, all of it. — Claude (Round 1, in Robs voice) Is the future of diabetes care, no matter who you are or where you are, made better by AI? Really something to think about. — Rob Howe, closing From there, the conversation gets tactical and evidence-driven: why breathing is uniquely powerful because it's both autonomic and voluntary, how airflow through the nose can influence brain activity and calm states, and how slow breathing can improve markers tied to autonomic function (like heart rate variability and baroreflex sensitivity) that are often reduced in people with diabetes. Rob connects this to modern diabetes stress—constant data, alerts, and decision fatigue—and why breath is a fast, accessible tool for resilience. Nick addresses the “woo vs. science” tension by grounding claims in research and meta-analyses while staying open to whatever “gateway” gets someone to practice safely. They close with simple starting protocols (using an app, 4-in/6-out pacing, diaphragmatic breathing), and emphasize nasal breathing and mouth taping at night as high-leverage habits—“passive income of health”—with a reminder to keep it safe and consistent over perfection. Chapters: 00:15 Insulin Sensitivity Playbook + Meet “The Breathing Diabetic” 01:27 Diagnosis Story: Age 11, DKA, and the “Diet Coke” Moment 02:48 The “Second Diagnosis”: Mid-20s Wake-Up and Lifestyle Control 03:58 From Air Quality Scientist to Breath Nerd: Discovering Wim Hof 04:51 The Oxygen Advantage: Nasal Breathing, CO₂, and a Breakthrough 08:52 Breath Goes Mainstream: James Nestor Validation + Confidence to Share 11:50 Why Breath Is a Superpower: Autonomic + Voluntary = A Lever 15:11 The Brain Angle: Nasal Airflow, Brainwaves, and Calm States 18:06 Diabetes Physiology: HRV, Baroreflex, and Slow Breathing Benefits 35:52 Practical Protocols: 5-Min Minimum Dose, Apps, Ratios, Mouth Tape Resources: The Breathing Diabetic Instagram The Breathing Diabetic Website

This episode dicusses the role of the 340B Drug Pricing Program in public health infrastructure, state and federal legislative reform of the program, the advocacy role of health systems and pharmacy teams, and the differing views shared by health systems and pharmaceutical manufacturers regarding 340B legislative reform.  Listeners will learn the background and purpose of the 340B program, ongoing efforts to reform the program at the state and federal levels, and what actions are commonly undertaken to influence  reform and the differing views held by 340B stakeholders.  The information presented during the podcast reflects solely the opinions of the presenter. The information and materials are not, and are not intended as, a comprehensive source of drug information on this topic. The contents of the podcast have not been reviewed by ASHP, and should neither be interpreted as the official policies of ASHP, nor an endorsement of any product(s), nor should they be considered as a substitute for the professional judgment of the pharmacist or physician.

340B Insight wants to make our podcast the best it can be. To help us succeed, we'd like to hear your thoughts. Please take just a few minutes to complete our listener survey, and we will enter you in a drawing to win a $100 gift card! To participate, please go to 340bpodcast.org/survey.One of the most important responsibilities hospitals have in maintaining 340B compliance is effective and accurate inventory management, but how do hospitals juggle data from multiple systems and minimize discrepancies? Christina Carrizales Cortez, associate director of 340B compliance for UI Health in Chicago, outlines some of the common inventory issues she encounters and explains how her team works to prevent and fix discrepancies.340B Discrepancies Can Come From a Variety of SourcesChristina says that because 340B compliance relies on monitoring and analyzing a multitude of data feeds, inventory discrepancies can come in multiple forms. A wholesaler might lack an electronic interface — meaning items must be manually entered and verified by the hospital team. Accounts might not have up-to-date inventory locations and addresses. Test claims, a practice by which pharmacies ascertain the cost to a patient of certain drugs, can lead to discrepancies if they do not end up dispensing those drugs.Understanding Systems Can Be Key to Reducing DiscrepanciesChristina says that the terminology and quirks of 340B can introduce confusion. One remedy, she says, is to explain 340B better so non-340B staff can understand it. Breaking down the basics of 340B and explaining its intricacies can go a long way in rooting out common pain points.Other Tips for Reducing DiscrepanciesChristina finds that comprehensive monthly reviews are an excellent way to find mismatches, as are instituting different checkpoints in the review process. Analyzing data points such as timestamps can reveal patterns for hospitals. Mapping out all vendors and routinely auditing split-billing software can help ensure better compliance as well.ResourcesFederal Court Decides HRSA Child Site Eligibility Restrictions Are Unlawful

In this episode, AJ Rivosecchi, Product Director at Bluesight, explores how health systems are rethinking pharmacy procurement as a strategic function amid rising complexity, drug shortages, and 340B uncertainty. He shares how integrating data across supply chain, finance, and compliance can improve resilience, protect margins, and support better decision making.This episode is sponsored by Bluesight.

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 Appropriations Act, including the impact that these changes will have on 340B hospitals. They'll also share some initial reactions to the Albany Medical Health System v. HHS court ruling out of the DC District Court, which has resulted in the vacating of HRSA's policy notice from October 2023 that addressed 340B child site eligibility timing. 

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 discuss the nature of the info requested by HRSA in the RFI, thoughts around including confidential/sensitive information in responses, and general strategies for providing constructive feedback to HRSA regarding an important potential change to the 340B Program. In the intro, Greg and Rob discuss some challenges with MFP refund reconciliation, and also review recent manufacturer policies requiring claims submission for 340 pricing access.

After a turbulent 2025, the early months of 2026 are proving that the policy landscape isn't quieting down. Federal agencies are rolling out new payment models, lawmakers are revisiting long debated rules, and courts continue to shape what policies move forward and which stall. From value based payment to drug pricing and site of care policy, leaders are navigating a fast shifting environment with real implications for finances, operations, and long term strategy. In this episode, host Abby Burns invites three Advisory Board experts to break down the major policy forces that leaders need to watch now: [1:35] Clare Wirth explains the newest wave of value based payment models out of CMMI, and what they signal about this administration's posture toward value-based care. [10:20] Nick Hula explores how site neutral payments, the return of inpatient only list changes, and state level certificate of need laws could accelerate site of care shifts. [20:51] Chloe Bakst unpacks the chaos surrounding 340B — from the halted rebate pilot to impacts of HR1 and emerging state reporting requirements — and the decisions leaders must make today to prepare for what's coming next. We're here to help: Webinar | How to be successful under TEAM Cheat sheet | 340B Drug Pricing Program Ready-to-Use Resource | Policy Scenario Impact Calculator Expert Insight | How policy changes will impact your bottom line Expert Insight | Inside CMS' final rule changes for 2026 Stay Informed | Healthcare Policy Updates Timeline Radio Advisory's Health Policy playlist Webinar | Join Optum Advisory experts at this upcoming webinar to learn how optimizing patient access unlocks the value of digital innovations and drives long-term sustainability A transcript of this episode as well as more information and resources can be found on RadioAdvisory.advisory.com.

Infusion services make up a roughly $150 billion market in the U.S., and underpin the financial stability of major service lines, especially oncology. Historically, health systems have enjoyed strong volumes, favorable reimbursement, and access to 340B discounts that keep their infusion business profitable. But rising competition, payer and employer driven site of care shifts, and looming policy changes are putting pressure on what many leaders have relied on as a stable, margin accretive business. In this episode, host Abby Burns sits down with Advisory Board expert Chloe Bakst to break down what's actually happening in the infusion market — and why every health system leader should be paying closer attention. Together, they explore how new competitors are capturing leakage you may not even see, how payers and employers are steering patients away from hospital outpatient departments, and how upcoming 340B reforms and Medicare drug price negotiations could reshape the economics of infusion over the next three years. Chloe also shares the strategies forward thinking systems are using to protect their infusion business and prepare for rapidly emerging headwinds. We're here to help: Webinar | The top trends in today's infusion market Tool | Market Scenario Planner Ready-to-Use Resource | Policy Scenario Impact Calculator Expert Insight | The 3 trends reshaping the specialty drug pipeline today Podcast | 270: Service line snapshot: What every health leader needs to know Webinar | Join Optum Advisory experts at this upcoming webinar to learn how optimizing patient access unlocks the value of digital innovations and drives long-term sustainability. Expert Insight | How data-driven risk reduction protects patients and providers A transcript of this episode as well as more information and resources can be found on RadioAdvisory.advisory.com.