Morning, Marco — hope the night was survivable. Quiet weekend for clinical
guidelines, but Washington had a loud week before leaving town: the 340B
fight now has two branches pulling in opposite directions, the CDC has a
confirmed director for the first time in a year, and the Senate spent
Tuesday arguing about the exact mechanism your hospital's Medicaid dollars
travel through. Coffee, ten minutes, then sleep.
ATop Stories
Update: A bipartisan Senate bill would kill the 340B rebate pilot HRSA just restarted
Three days after HRSA published its revised
340B Rebate Model Pilot Program
in the Federal Register (effective immediately, manufacturer plans due
August 24), the Senate's bipartisan "Gang of Six" — Capito, Moran,
Boozman, Baldwin, Kaine and Hickenlooper — introduced the
SUSTAIN 340B Act,
which would end the rebate pilot outright, codify covered entities'
use of contract pharmacies (with audits for entities running large
networks), and — for the first time in statute — define who counts as a
340B "patient."
Why it matters This is the same policy question you
read about here Tuesday, now being fought on two tracks at once: the
administration moving by notice, Congress moving by statute, in opposite
directions. Rebates change your pharmacy's cash flow (pay list price
up front, get money back later); the "patient definition" question changes
which of your discharges generate 340B savings at all. Both land on the
same rev-cycle and pharmacy teams.
Talking point When you ask pharmacy about the
Aug 24 deadline, add a second question: are they modeling the pilot
as permanent, or as something Congress may unwind? The answer changes
whether this is a workflow build or a bridge.
(McDermott+ Check-Up, Aug 7 ·
HRSA)
CDC has a confirmed director again — and that unblocks the vaccine pipeline you read about Wednesday
The Senate confirmed Dr. Erica Schwartz (MD, JD, MPH) as CDC director
Wednesday on a 51–44 vote — all Republicans plus Sen. Kaine — filling
a vacancy that had run nearly a year. Coverage landed through Thursday and
Friday.
Why it matters The CDC director is the person who
accepts or rejects ACIP recommendations, and those recommendations are what
trigger cost-sharing-free coverage in commercial plans and Vaccines for
Children. That sign-off channel has been empty. It's precisely the
bottleneck behind the mFlusiva problem from Wednesday's report — FDA
approved the product, but there was no functioning path from approval to
"your patient can actually get it covered." With a confirmed director,
that path exists again, whichever way she uses it. Note also that during
the vacancy HHS moved unilaterally on the pediatric schedule (including
delaying the hep B birth dose); the authority now sits with a Senate-
confirmed official.
Suggested action Worth a note to pharmacy and
infection prevention before September: the answer to "can we put this on
the discharge order set?" may change in the next 4–6 weeks, and you want
to be asking before flu season, not during.
(STAT ·
NPR ·
CNN)
Congress is gone until September — here's what's parked, and what still has an August clock
The Senate finished its business Friday and left for recess; the House
returns the week of Aug 31, both chambers the week of Sept 14. A
continuing resolution funding the government to December 11 passed
the Senate but still has to be reconciled with the House version. Nothing
legislative moves on health policy for three weeks.
Why it matters The regulatory clock, unlike Congress,
does not take August off. Three deadlines run while the Hill is empty:
Aug 24 — manufacturer plans for the 340B rebate pilot;
Aug 31 — comments on the CY2027 OPPS proposed rule (which includes
the survey-based 340B drug reimbursement proposal and price-transparency RFI);
Sept 14 — comments on the
CY2027 Physician Fee Schedule,
where the temporary 2.5% update from CY2026 expires and most specialties
see a net reduction.
Suggested action If your group has ever wanted to
file a comment as a group rather than let the hospital association speak
for you, the PFS window (Sept 14) is the one that touches your paycheck
most directly, and there's a full month of runway.
(Holland & Knight summary)
That's the lot. Nothing on today's list needs you before Monday — sleep well,
Marco.