Podcasts about 340b

America's economic center of gravity is moving south as people, paychecks, factories, ports, film production and political influence follow the Sun Belt. Austin examines what is powering the shift and whether Southern states can preserve affordability and culture as they grow. Camellia Petersen joins the debate over proposed federal childcare aid for married families with a stay-at-home parent, and Liz Mair explains why new 340B prescription-data demands could put patient privacy at risk. Follow Wake Up America on Apple Podcasts or Spotify so every new episode lands in your feed. Watch the full video.

In this episode, healthcare attorneys Joella Roland and Jason Reddish from Powers join to provide commentary on a variety of developments impacting 340B covered entities. They'll discuss ongoing manufacturer activity, from contract pharmacy restrictions to claim data submission requirements, and how 340B providers have been responding. They'll also share some opinions on how recent judicial rulings on HRSA policy, including child site eligibility timing and GPO Prohibition, have impacted regulatory enforcement of the 340B Program. They'll also offer some thoughts on how recent proposed CMS rules related to Medicare Part B billing and Medicare Part D 340B data collection will impact covered entities in the future. In the intro, Greg and Rob recap changes that have been made to the HRSA Data Request List for FY27. Save the date for our upcoming 340B CE webinar on Tuesday, September 29th. Questions?  Email us at 340BUnscripted@spendmend.com

In this episode, Albert L. Wright, Jr., President and Chief Executive Officer of West Virginia University Health System, joins the podcast to discuss the 340B program and the role of alternative payment models in shaping healthcare delivery. He also shares insights on keeping communities healthy and strengthening the health system's impact beyond traditional care.

This time on Code WACK! This time, we're taking a closer look at the federal 340B Drug Pricing Program. In a nutshell, the program gives hospitals and clinics that serve low-income and other vulnerable patients deep discounts on prescription drugs. But who really benefits from these discounts? Patients? Or hospitals? Did the legislation really intend that patients be charged coinsurance based on the full price of drugs that their hospital bought for far less? Let's explore why consumer advocates say the program needs reform. Today's guests are from the National Consumers League, Sally Greenberg, CEO and Lisa Bercu, Senior Director of Health Policy. The NCL is one of the nation's oldest consumer and worker advocacy organizations. This is the second episode in a two-part series. Check out the Transcript and Show Notes for more! And please keep Code WACK! on the air with a tax-deductible donation.

How the 340B Drug Discount Program Quietly Raises Costs for Self-Insured Employers. Episode 527. Why should a self-insured employer care about the 340B charity program? That's the single question Stacey Richter puts to Shawn Gremminger, president and CEO of the National Alliance of Healthcare Purchaser Coalitions, in this episode—and his answer traces four ways the $68 billion program quietly drives up what employers and plan sponsors pay for drugs and medical care. From supercharged hospital consolidation to disappearing PBM rebates, Gremminger lays out why 340B, once treated as a niche topic, now sits squarely at the center of the drug pricing debate. WHAT YOU'LL LEARN ✅ Why 340B—now the second-largest drug purchasing program in the country at roughly $68 billion a year—matters directly to self-insured employers, not just to pharma and hospitals ✅ How 340B-driven hospital consolidation pushes up prices for all services, not just drugs, since hospital spend typically makes up 55–58% of total employer health plan costs ✅ Why 340B hospitals tend to mark up drugs even more aggressively than non-340B hospitals, and why 340B clinics disproportionately prescribe higher-priced drugs over cheaper alternatives ✅ How the Inflation Reduction Act's drug price caps are reportedly pushing some 340B entities to nonmedically switch patients toward non-IRA, higher-margin drugs ✅ Why employers lose access to PBM-negotiated rebates entirely whenever a drug is purchased through the 340B channel instead of the traditional channel ✅ Why Shawn Gremminger argues employers, purchasers, and policymakers need to stop treating 340B as a separate, carved-out issue from the broader drug pricing debate WHY THIS MATTERS Hospital spend already makes up more than half of a typical self-insured employer's healthcare costs, and 340B's distortions—inflated markups, prescribing skewed toward higher-priced drugs, and vanishing rebates—flow straight into that spend. A recent study found that for every point increase in hospital prices, non-healthcare employers respond by cutting payroll and jobs for middle-class workers. As 340B has grown from a niche $5–10 billion program into a $68 billion one, treating it as someone else's problem is no longer an option for anyone trying to understand or control drug pricing. MENTIONED IN THIS EPISODE Article: Brian Reid's Cost Curve Weekend newsletter, on pharma-hospital data-requirement lawsuits LinkedIn Post by Peter Hayes Article: "Reforming 340B to Serve the Interests of Patients, Not Institutions," by Anthony DiGiorgio, DO, MHA Article: "How a Company Makes Millions Off a Hospital Program Meant to Help the Poor," New York Times EP448 (Part 1 and Part 2) with Shawn Gremminger: Apple Podcasts | Spotify | Other Apps Study: Zack Cooper, PhD, on rising healthcare prices driving unemployment and job losses LinkedIn Post by Shawn Gremminger === LINKS ===

In this episode, Carlos Bohorquez, CFO, UC San Diego Health, discusses the system's growth strategy, its Joint Powers Authority with Palomar Health and the financial challenges facing health systems, including HR1, 340B and potential site-neutral payments. He also shares how UC San Diego Health is using long-term planning, data-driven decision-making and a focus on its workforce to navigate uncertainty and support continued growth.

A key dimension to navigating 340B involves data, because the way hospitals and their pharmacies crunch numbers can be key to avoiding compliance issues and finding new opportunities to improve savings and patient access to care. Saint Francis Health System's 340B Program Manager Ted Houston tells us how his health system is getting the most value out of all the data.Compliance and Savings OpportunitiesHouston says his health system has put in a lot of work with its enterprise and data analytics team to align what the electronic health record system is exporting to what drug companies are demanding in order to improve compliance. But he said improving reports also led to additional savings for his system, as some claims were miscategorized within third-party administrator systems. Data Consolidation, Better WorkflowsHouston said health systems can improve their data monitoring by reducing individual data sources — for example, by using a standardized data extract from a third-party administrator and using tools to scan for certain types of claims. Saint Francis found success with improving oncology medication workflows, finding tens of thousands of dollars' worth of eligible savings on certain oncology medicines.Investing in Better Data Quality, Not VolumeTo improve data collection, Houston said self-education — both about different analytical resources and what use cases would have the biggest impact — is critical to optimizing data. Those tools may cost money, but it is important to concisely communicate the value proposition for compliance or savings when investing in new tools to improve how hospitals gather and process data.Resources:Episode 140: What Illinois 340B Advocates Did To Succeed on 340B ProtectionsIllinois Governor Signs 340B Contract Pharmacy Protections as Drugmakers File Lawsuits

This time on Code WACK!   This time, we're taking a closer look at the federal 340B Drug Pricing Program. In a nutshell, the program gives hospitals and clinics that serve low-income and other vulnerable patients deep discounts on prescription drugs. But who really benefits from these discounts? Patients? Or hospitals? Did the legislation really intend that patients be charged coinsurance based on the full price of drugs that their hospital bought for far less? Let's explore why consumer advocates say the program needs reform. Today's guests are from the National Consumers League, Sally Greenberg, CEO and Lisa Bercu, Senior Director of Health Policy. The NCL is one of the nation's oldest consumer and worker advocacy organizations. This is the second episode in a two-part series.  Check out the Transcript and Show Notes for more! And please keep Code WACK! on the air with a tax-deductible donation.  

This time on Code WACK! This time, we're taking a closer look at the federal 340B Drug Pricing Program. In a nutshell, the program gives hospitals and clinics that serve low-income and other vulnerable patients deep discounts on prescription drugs. But who really benefits from these discounts? Patients? Or hospitals? Did the legislation really intend that patients be charged coinsurance based on the full price of drugs that their hospital bought for far less? Let's explore why consumer advocates say the program needs reform. Today's guests are from the National Consumers League, Sally Greenberg, CEO and Lisa Bercu, Senior Director of Health Policy. The NCL is one of the nation's oldest consumer and worker advocacy organizations. This is the second episode in a two-part series. Check out the Transcript and Show Notes for more! And please keep Code WACK! on the air with a tax-deductible donation.

This podcast discusses the Centers for Medicare & Medicaid Services (CMS) Outpatient Prospective Payment System (OPPS) proposed rule, with a focus on its cuts to the 340B Drug Pricing Program. We discuss CMS's proposed cuts to 340B reimbursement and proposed changes to recoupment of 340B overpayments from 2018 – 2022, as well as how these changes interact with other challenges to the 340B program.   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 this episode, Greg and Rob are joined by healthcare attorney Kyle Vasquez to discuss the recently released CMS 2027 OPPS proposed rule. They'll review key provisions in the policy that could impact 340B hospitals, including significant changes to billing requirements, reimbursement rates, and changes to CMS implementation of provider-based criteria for offsite outpatient departments. Earlier in the episode, the guys catch up on 340B news. Questions for us? Email us at 340BUnscripted@spendmend.com

Emily J. Cook, Partner, McDermott Will & Schulte, and Kelsey Bagheri, Principal Counsel, UCSF Health, discuss how covered entities and their legal counsel can navigate the current legal and compliance risks associated with the 340B program. They cover recent developments in the 340B program, top 340B compliance myths, the role of pharmacies in 340B oversight, how covered entities can ensure that 340B risks are understood across the entire organization, issues related to vendor arrangements and manufacturer inquiries, and how in-house counsel can make the greatest impact. Emily spoke about this topic at AHLA's 2026 Institute on Medicare and Medicaid Payment Issues in Baltimore, MD.Watch this episode: https://www.youtube.com/watch?v=ci7l-2c6e60 Learn more about AHLA's 2026 Institute on Medicare and Medicaid Payment Issues: https://www.americanhealthlaw.org/medicaremedicaidLearn more about AHLA's 2026 Medicare and Medicaid eProgram: https://educate.americanhealthlaw.org/local/catalog/view/product.php?productid=1759 Essential 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/. 

Much like the iconic TV commercials in which the late newscaster John Cameron Swayze would demonstrate on live television how the venerable Timex wristwatch could withstand relentless beatings and “could keep on ticking,” the venerable federal drug program, 340B, continues in its role to provide expensive drugs at discounted prices to the nation's safety-net hospitals.Due to recent legislation introduced in Congress to make comprehensive changes to the federal 340B drug pricing program, the producers of RACmonitor have invited attorney Jeff Davis with the law firm of Bass, Berry & Sim, to summarize key provisions, the potential impact of the legislation on 340B providers and the likelihood of enactment.The broadcast will also include these instantly recognizable segments:• Monday Rounds: Ronald Hirsch, MD, vice president of R1 RCM, will make his Monday Rounds.• The RAC Report: Healthcare attorney Knicole Emanuel, a partner at the law firm of Poyner Spruill, will report the latest news about auditors.• Risky Business: Healthcare attorney David Glaser, a shareholder in the law offices of Fredrikson & Byron, will join the broadcast with his trademark segment.• Legislative Update: Cate Brantley, legislative affairs liaison for Zelis, will report on current healthcare legislation.

In this episode, Greg and Rob cover a couple of hot topics in the 340B community. First, they will discuss the recently published HRSA notice regarding a 340B Rebate Model Pilot Program, which is set to initiate in January 2027. They discuss what the operational changes might look like for covered entities, and identify key upcoming dates in HRSA's implementation timeline. Then, they discuss the recently introduced SUSTAIN 340B Act, a bipartisan Senate bill that addresses extensive 340B Program reforms.  They debate the merits of various provisions in the bill from the perspective of the covered entity, and share opinions on how this might advance through the legislative process.  HRSA Notice Regarding 340B Rebate Model Pilot Program: https://public-inspection.federalregister.gov/2026-15633.pdf  List of Drugs Subject to 340B Rebate Model: 340B Rebate 2026 Chart.pdf SUSTAIN 340B Act: https://www.moran.senate.gov/public/_cache/files/1/6/169a3bd3-466d-43ee-a15a-2d1f7a3506ca/56EA0919A4EEBD88A3E23AF3E1F6ED76A051C57C7E9B30FB4D1CC9E15FC3FE32.340b.pdf   Questions, comments?  Email us at 340BUnscripted@spendmend.com 

Mid-August to mid-September marks the time every year when hospitals need to recertify for 340B. Failure to recertify in time could cost a hospital its ability to participate in 340B. 340B Health Associate Director of Policy and Compliance Rebecca Swartz joins us to walk listeners through the process.Why recertification is “exceptionally important”Swartz says annual recertification is not just important, it's also one of the central tenets of 340B compliance. All hospital types except critical access hospitals need to make sure they're meeting the minimum disproportionate share percentage threshold. Hospitals also need to affirm that they are nonprofit facilities and that all their registered parent and child sites continue to have reimbursable outpatient costs and charges on their Medicare cost reports.The cost of losing eligibility is highFailure to recertify 340B eligibility in a timely manner can lock hospitals out of their access to 340B pricing for a year or more. That could deprive a hospital of crucial resources to provide the care and support its patients need.Tips for a smooth recertificationSwartz says a key to making the process go smoothly is to start early and make sure hospital officials have the necessary worksheets and other documentation before the recertification process begins. Authorized officials (AOs) and primary contacts (PCs) should be on the lookout for returned tasks from the Health Resources & Services Administration (HRSA) and other messages to ensure their recertification process is complete. Taking screenshots of each step of the process also can help identify and fix discrepancies that might arise.ResourcesHospital Recertification Begins Aug. 10, Prepare Now!340B Health Registration and Recertification Resource Page340B Health Webinars

A 111-year-old Detroit institution is making one of the biggest bets in Michigan health care, and the details are more ambitious than a new building. From the Mackinac Policy Conference, we talk with Denise Brooks Williams, Executive Vice President and Chief Operating Officer of Henry Ford Health System, about the “Future of Health” initiative and what it takes to modernize a flagship campus while keeping community needs at the center.We get into Destination Grand, a roughly 1.2 million square foot, $2.2 billion hospital project on West Grand Boulevard. Denise explains how all private rooms, a redesigned emergency department with a stronger behavioral health focus, updated operating rooms, and new technology infrastructure are meant to change the experience of care, not just the skyline. Just as important, we discuss how Henry Ford worked through Detroit's community benefit ordinance process to hear directly from residents about affordability, access, transportation, and the kinds of services that make a medical district usable in everyday life.The conversation also widens to statewide access. With Henry Ford Health's joint venture with Ascension and partnerships across Michigan, we talk about how specialty expertise can show up closer to home in communities like Jackson, Genesee County, and beyond, while still creating a clear path to advanced care when needed.Finally, we tackle the policy headwinds shaping the future: the 340B drug pricing program, Medicaid reimbursement, and why “common ground” matters if we want sustainable healthcare affordability and access for Michigan patients. If you care about Detroit hospital development, Michigan health policy, and what real community-centered healthcare delivery looks like, hit subscribe, share this with a friend, and leave a review so more people can find the show.Support the showEngage the conversation on Substack at The Common Bridge!

Good morning from Pharma Daily: the podcast that brings you the most important developments in the pharmaceutical and biotech world. Today, we delve into recent transformative events that are shaping this dynamic industry, from strategic mergers to groundbreaking drug approvals. Starting with the merger between Supernus Pharmaceuticals and Indivior Pharmaceuticals, this all-stock deal valued at $2.2 billion is set to create a powerhouse focused on central nervous system (CNS) disorders. By combining their resources, the new entity is expected to enhance its capabilities in neurological disorders with a robust portfolio of approved drugs. This merger allows the companies to leverage economies of scale, optimize research and development, and expand their market presence, offering promising prospects for advancements in treating CNS-related conditions. In regulatory news, Novartis has secured FDA approval for an expanded indication of Pluvicto (lutetium vipivotide tetraxetan), a radioligand therapy originally approved for PSMA-positive metastatic castration-resistant prostate cancer. This therapy can now be used for metastatic hormone-sensitive prostate cancer, marking a significant step forward in prostate cancer treatment. By targeting prostate-specific membrane antigen (PSMA) with precision, Pluvicto offers the potential for improved patient outcomes and highlights the growing role of radioligand therapies in oncology. Globally, Pharmamar's Zepzelca (lurbinectedin) has been approved in Canada, Qatar, and South Korea as a first-line maintenance therapy for extensive-stage small cell lung cancer. This approval signifies a potential shift in how aggressive cancer types are treated, particularly when combined with PD-L1 inhibitors, opening new avenues for effective combination therapies. Industry partnerships continue to drive innovation, as seen with Fujifilm and Taiho Pharmaceutical's collaboration to develop next-generation antibody-drug conjugate (ADC) manufacturing technologies using the Aralinq platform. With ADCs becoming increasingly pivotal in targeted cancer therapies due to their precision in delivering cytotoxic drugs to tumor cells, advancements in manufacturing could significantly enhance production capabilities and therapeutic efficacy. Financial dynamics within the industry remain robust. AbbVie has raised its 2026 revenue forecast to $67.6 billion, citing strong performances from its immunology drugs Skyrizi and Rinvoq. These therapies have shown substantial success in treating autoimmune conditions, reflecting their impact on AbbVie's financial health and reinforcing confidence in their commercial viability. On the clinical trial front, Ratio Therapeutics has successfully closed a $70 million Series C funding round to support its radiotherapeutics pipeline and initiate the ATLAS trial. This infusion of funds underscores the continued interest and investment in radiopharmaceuticals with promising applications in oncology. The landscape of mergers and acquisitions remains active as AstraZeneca and Bristol Myers Squibb reportedly engage in early-stage merger discussions. Such a merger could create an oncology giant valued at approximately $400 billion, potentially reshaping competitive dynamics and accelerating innovation across therapeutic areas. Regulatory changes are also underway with HRSA advancing a revised 340B rebate model pilot program despite hospital opposition. The implications for healthcare providers are significant as this could affect operational efficiencies and financial strategies within participating entities. Overall, these developments reflect ongoing trends toward industry consolidation and strategic partnerships that foster innovation in drug manufacturing technologies. Regulatory approvals continue to advance precision medicine through targeted therapies, showcasing the sector's dynamic nature as it addresses unmet medical needs while navigating complex regulatory environments. Meanwhile, Sandoz's settlement of nearly $500 million for antitrust claims in the U.S. highlights ongoing scrutiny of industry competition practices. This settlement signals potential shifts in market dynamics as companies seek to resolve legal challenges while maintaining operational integrity. Cybersecurity has emerged as a critical concern following Amgen's reported breach compromising sensitive patient data. This incident amplifies the need for enhanced data protection measures to safeguard information integral to patient trust and competitive integrity. In leadership news, BioNTech has appointed Guido Oelkers as CEO amid its continued innovation in mRNA technology post-COVID-19. This strategic move underscores BioNTech's commitment to leadership capable of navigating advances in mRNA therapeutics. Lastly, Novo Nordisk faced setbacks with its investigational therapy ziltivekimab failing a phase 3 trial targeting inflammatory pathways for cardiovascular outcomes. Despite such challenges, these high-stakes trials highlight both risks and opportunities inherent in pharmaceutical innovation. As we reflect on these stories, it's clear that scientific advancements, regulatory developments, and strategic business moves continue to shape the trajectory of the pharmaceutical and biotech sectors. These efforts promise significant implications for future drug development and patient care as companies strive to harness breakthroughs while adapting to evolving industry landscapes.Support the show

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)

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

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.