A federal judge dismissed a move to block 340B cuts days before CMS’ final rule on it went into effect.
Days before CMS’ final rule on 340B went into effect, a federal judge dismissed a move to block the sharp cut to hospital reimbursements.
The American Hospital Association (AHA), America’s Essential Hospitals, and the Association of American Medical Colleges sued HHS last year to block the 2018 Medicare Outpatient Prospective Payment System rule that would cut $1.6 billion to the Medicare program. US District Judge Rudolph Contreras tossed the case, saying that the suit was premature since the changes hadn’t yet taken effect.
With the cuts now in effect as of January 1, 340B hospitals will receive smaller reimbursements for drugs purchased through the program. Under the old calculation, hospitals received 6% plus the average sales price of the drug; now, hospitals will receive the average sales price minus 22.5%. Rural sole community hospitals, certain cancer hospitals, and children’s hospital will be exempt from the reductions. According to CMS, the savings will be redistributed equally to hospitals covered under the rule. In addition to the cuts, 2 modifiers will be put in place in order to identify whether a drug was purchased under the 340B program.
“Making cuts to the program, like those [the CMS] has put forward, will dramatically threaten access to health care for many communities with vulnerable patients," said Rick Pollack, president and CEO, AHA, in a statement following the ruling. "We are disappointed in this decision from the court and will continue our efforts in the Courts and the Congress to reverse these significant cuts to the 340B program.”
Current and Emerging Options for Uncommon EGFR- and Exon 20 Insertion–Mutated NSCLC
September 8th 2025Uncommon EGFR mutations in non–small cell lung cancer (NSCLC) remain challenging to treat, but new tyrosine kinase inhibitors, bispecific antibodies, and a proposed “PACCage insert” framework provide opportunities to advance precision therapy.
Read More
Exploring Racial, Ethnic Disparities in Cancer Care Prior Authorization Decisions
October 24th 2024On this episode of Managed Care Cast, we're talking with the author of a study published in the October 2024 issue of The American Journal of Managed Care® that explored prior authorization decisions in cancer care by race and ethnicity for commercially insured patients.
Listen
Evolving Roles of Antibody-Drug Conjugates in the Treatment of NSCLC
September 7th 2025Antibody-drug conjugates are rapidly reshaping the treatment landscape of non–small cell lung cancer (NSCLC), with advances in design, clinical efficacy, and regulatory approvals tempered by ongoing challenges in toxicity, resistance, and biomarker optimization.
Read More
From Amivantamab to Next-Generation Therapies: The Evolving Bispecific Antibody Landscape in NSCLC
September 6th 2025Bispecific antibodies are emerging as a transformative class in advanced non–small cell lung cancer (NSCLC), with agents such as amivantamab and zenocutuzumab already demonstrating clinical benefit and a broad pipeline of investigational therapies showing promise in overcoming resistance.
Read More