Latest news with #SenateBill118
Yahoo
14-04-2025
- Health
- Yahoo
What is 340B and how does it impact hospitals' bottom line?
() A somewhat obscure federal program designed to reduce drug prices for health providers is getting scrutiny from lawmakers this year, with many questioning whether those savings are being used effectively for underserved patients. As designed, the 340B program requires participating manufacturers to sell discounted drugs to providers seeing low-income and underserved populations. Between 2005 and 2023, the program's total drug purchases grew from $2.4 billion to $66.3 billion — with the explosive growth exposing a rift between the pharmaceutical companies supplying the discounts and the hospitals receiving them. In response, state legislators are considering a bill to establish reporting requirements on qualified 340B entities, with a special focus on the dozens of hospitals accessing low-priced medications. 'Transparency has been kind of a key word for everything we've done this session — for the last couple of sessions — and this is focusing a light,' said Sen. Ed Charbonneau, who authored the proposal. 'What's going on is legal, but it is far askance from the purpose of what the whole thing was — to provide low-cost medications to the indigent people needing help.' Senators opted not to concur with House amendments, sending Senate Bill 118 to a conference committee to finalize negotiations. But the latest version would require certain health providers under the program report: aggregate drug acquisition costs and payments, pharmacy dispensing payments, claims, how 340B savings were used, patient makeup and more. But for some of the small hospitals using the program, every dollar saved is vital to continue their services. 'We don't have the economies of scale that larger tertiary centers have. We have to make do with very little oftentimes,' said Brenda Reeta, the CEO of the Greene County General Hospital. 'The cuts are getting deep enough now that it's going to be bordering on … not just cutting service lines but, 'Can we even stay open?'' In committee testimony, much of the program's criticism can be summarized by William S. Smith, a senior fellow overseeing life science initiatives at the Pioneer Institute think tank in Boston. Smith presented roughly 15 slides before both Senate and House committees in January and March describing how hospitals, clinics and pharmacies can acquire medications at a 'deep, deep' discount and then bill private insurers the full price — keeping the difference in a practice known as arbitrage. 'Arbitrage drives this and that creates all sorts of bad incentives for the program because hospitals have every reason to bring in fully insured patients and not to treat uninsured patients,' Smith told senators in January. As evidence of this practice, Smith pointed to the opening of contract pharmacies affiliated with 340B entities in wealthy communities with high rates of private insurance. 'Jeff Bezos could walk into a 340B pharmacy and get a 340B drug,' Smith said. 'It should be targeted for low-income patients or uninsured patients, in my view.' An Indiana one-pager from Pioneer concludes that more than half of these contract pharmacies are in affluent neighborhoods, dispensing drugs on behalf of 340B entities. Some of the state's largest nonprofit hospitals use contract pharmacies based in California and Hawaii, a point of contention for Pioneer. Additionally, Smith criticized a decline in reported charity care. Lawmakers have amended the bill to exclude reporting requirements for 340 entities like Health Resources and Services Administration clinics. Programs under that umbrella include programs like the Damien Center's services for Hoosiers with HIV or the Indiana Hemophilia and Thrombosis Center. Such clinics testified that they are already subject to stricter reporting requirements and auditing than hospitals. 'I think clinics are different than hospitals. The clinics, generally, run things better. They're audited on their charity care,' Smith said. '… and some hospitals are under-reimbursed by Medicaid and they really depend on 340B. That's why I like (Senate Bill 118) because it doesn't undercut the program. It just says, 'What's going on? How much money are you making?'' Before House lawmakers in March, Smith doubled down, targeting larger hospital systems for additional scrutiny. 'They're cutting back on their charity care and … collecting tens of millions of dollars in revenue from 340B. I'd like to find out which hospitals are doing the right thing and which ones are not and a little transparency would help,' Smith said. Such concerns have reached Gov. Mike Braun as well, who issued an executive order in January ordering Health and Family Services Secretary Gloria Sachdev to examine the program and determine what oversight the state could pursue. Such a review is set to be finalized by the end of October. Pushing back, hospitals said the savings from 340B weren't ever meant to go directly to patients — something Smith also said. But rather, hospital administrator said, it offsets other programming. 'If we focused on charity care, it suggests that our savings should be solely used to support charity care versus stretching scarce resources,' said Dawn Moore, a vice president and chief pharmacy officer with Community Health Network testifying on behalf of the Indiana Hospital Association. Moore additionally noted that charity care 'only' considered services that were billed and then written off, leaving out free clinics, patient navigation services and more. 340B savings were generated when billing a private insurer, since the program can't be applied to medications under Medicaid — hence why contract pharmacies may not be located in low-income areas. An obscure drug discount program stifles use of federal lifeline by rural hospitals 'We set up or provide services all throughout. However, because we generate a savings from locations where we have commercially insured patients, we take those savings and reinvest them where they're needed,' Moore said. Reetz, with the Greene County hospital, estimated that her hospital got roughly $500,000 in benefits from 340B but spent nearly half of that on self-auditing and administration. Though comparatively small, having that cushion allowed her system to keep its obstetrics and gynecology service lines open as well as cardiopulmonary rehabilitation. 'We are one of the few rural communities that still has full OB services … It's very costly to keep an OB department open and we have chosen to do that because, for us, it would be over an hour away for most of our community members to travel to deliver a baby,' said Reetz. 'Within the last couple of weeks, we had a person come in that did not plan to deliver at our hospital but the baby was coming right now. 'It was a complicated pregnancy and had she not been able to have an emergency (caesarean) section right then and there, the baby would have most definitely not made it. And most likely the mom too,' Reetz continued. Additional reporting requirements could eat into that money recouped from 340B, Reetz worried, on top of the other reporting and transparency requirements imposed on hospitals. Unlike other programs, no tax dollars are spent under the 340B program. 'I don't necessarily get why they're trying to push for more transparency, because I believe it's already as transparent as we can possibly be with it. It is just going to further dip into how much we actually are able to benefit from the program by making the administration of it even more costly,' Reetz said. SUBSCRIBE: GET THE MORNING HEADLINES DELIVERED TO YOUR INBOX
Yahoo
01-04-2025
- Politics
- Yahoo
Does Florida need a Trump library or are lawmakers worshipping at the altar again?
Florida lawmakers, bless their hearts, are already angling to bring a future Donald Trump presidential library to the state. And they don't want any Trump-critical counties like Palm Beach County getting in the way. I know what you're thinking. What's the rush in planning? It might be prudent to allow Trump's presidential legacy to marinate in a little history before we hastily commit to encouraging something as plainly preposterous as a 'Trump library.' After all, it's still to be determined whether he uses the military against U.S. citizens, invades a former ally, jails opposition lawmakers or declares himself above the dictates of the U.S. Supreme Court — all outcomes well within the bounds of possibility. So what's the rush for a presidential library? It's not like Trump even reads. This can wait. If we rush this, we're just guaranteeing that future generations will marvel at the depths of our collective blindness. But no, Florida lawmakers appear to have an incurable case of premature adulation, as they push a law that would prevent local governments in the state from having any regulatory authority over a Trump library in their city or county. 'In anticipation of Florida's first presidential library, we should roll out the welcome mat and offer the president maximum flexibility to construct this historic landmark in Florida,' Senate Bill 118's sponsor, state Sen. Jason Brodeur, R-Sanford, told his colleagues. 'The protections in this bill will prevent any municipality from imposing frivolous obstacles to the establishment of a presidential library within the state." I think he's talking about us. NBC News has already reported that a presidential team is looking at Florida Atlantic University in Boca Raton as a potential site for the library. The idea is that it would be relatively near Trump's winter retreat, Mar-a-Lago in Palm Beach. Although Trump won Florida in the last three general elections, he lost Palm Beach County every time. So, a Trump library in Boca Raton is not going to be as welcomed as it might be in say, Sarasota, Pensacola or Jacksonville. I guess that's why Republican lawmakers are trying to take local control away from a future site of the library. This means that whatever over-the-top, garish self-tribute Trump designs for himself will be something the people in the area of the library will have to stomach. Just as his flagpole at Mar-a-Lago had to be the biggest pole in Palm Beach in violation of local zoning regulations, his presidential library will undoubtedly have to be the biggest, most garish display of them all, maybe with the word 'TRUMP' flashing down on the community in nightly drone light shows. Opinion: Trump doesn't care about 'working from home' when he's doing it at Mar-a-Lago I envision Boca Raton turning into a kind of America's Pyongyang with a giant golden Trump statue outside a library building — one visible from miles around. And I can see the outside of the library ringed with scores of life-sized stainless steel statues (like the Korean War Veterans Memorial in Washington, D.C.) as a representation of an overflow crowd of people who want to get in the library, but can't because it's already full of worshippers. Under the proposed bill, the city and county selected to house the library will have no say on the building's height, appearance or any tasteless aesthetics that Trump might dream up. It could violate any and all local zoning laws without recourse. Brodeur predicted that a Trump library 'would be one of the biggest attractions ever built in Florida.' I don't know about that. I would think it would be a considerable challenge to fill it. What are we talking about here? A hall of Tweets? A display of paper shredders? A collage of untrustworthy golf scorecards? The Four Pinocchios Cafe? Maybe a re-creation of the Mar-a-Lago bathroom used to store top-secret government documents? Opinion: I don't care if they rename Southern Boulevard for Trump. But let locals decide. Let's keep this in mind: a Trump library is optional. Not every president gets a presidential library. There are currently just 13 presidential libraries. They are overseen by the National Archives and Records Administration (NARA). That's the organization that tried to recover the government documents Trump kept after losing the 2020 election, so it's not his favorite group. Trump just fired the head of the National Archives in February, evidence that he is apparently still stewing in contempt over the group's mission to preserve the records of his administration. So, why not just put the Trump library idea on ice, at least until after we find out whether a nation of willfully blind elected cowards will allow him to complete the takeover of the other two branches of government? In the meantime, I'm confident that Florida lawmakers can find some other less egregious ways to dream up performative acts of fealty to Trump. Frank Cerabino is a news columnist with The Palm Beach Post, which is part of the USA Today Network - Florida. He can be reached at fcerabino@ This article originally appeared on Palm Beach Post: Trump library coming? Florida lawmakers want us to butt out | Opinion
Yahoo
24-02-2025
- Politics
- Yahoo
KY kids, economy would gain if lawmakers adopt alternatives to imprisoning parents
One in 10 Kentucky children have experienced the incarceration of a parent — trauma that can have lifelong consequences.(Getty Images) Settling into the year 2025, it feels as if America is divided right down to its foundation. Finding common ground across the ever-widening gap feels next to impossible, but in Kentucky two organizations on opposite sides of the political spectrum are coming together to reexamine and improve the American criminal justice system. The organizations we represent — KY FREE and — bring different perspectives to criminal justice policy. KY FREE, a voice for free-market principles, offers a center-right point-of-view to criminal justice and public safety policy coalitions. on the other hand, takes a more progressive approach by raising awareness, promoting harm reduction, advocating for policies which create safe environments for those who struggle with substance use disorders, and fighting to end mass incarceration. Yet, we stand united in support of the House Bill 291 and Senate Bill 118 Family Preservation and Accountability Act, an approach that takes a compassionate, solutions-focused approach to addressing the root causes of crime, while simultaneously safeguarding family stability. Modeled after successful programs in other states and recently adopted in Tennessee, this innovative legislation offers community-based alternatives to incarceration for parents convicted of nonviolent offenses. Instead of separating families, the act provides practical, evidence-based solutions such as: Vocational training and educational programs to empower individuals to build stable, productive lives. Therapy to address mental health challenges and trauma. Case management to help individuals navigate systems and access resources. Recovery services to support people struggling with substance use. Parenting classes to strengthen family bonds and equip parents with the tools to succeed. One in 10 Kentucky children have experienced the incarceration of a parent — trauma that can have lifelong consequences. By tackling the underlying issues that often lead to crime, the Family Preservation and Accountability Act ensures accountability while reducing the devastating impact of parental incarceration on children. This legislation will also strengthen the state's economy. A recent report released by KY FREE estimates that Kentucky would not only save $74 million in direct incarcerations costs per year, but add $740 million annually to the state's economy through indirect societal and economic cost savings. By keeping parents in their communities and out of incarceration, they can continue working, supporting their families and contributing to the local workforce. Stable employment reduces recidivism and helps families achieve financial independence. This represents a significant shift towards prioritizing safety and rehabilitation over separation. By investing in community-based supports, Kentucky can foster healthier families, stronger communities and a brighter future for its children. We urge Kentucky lawmakers to come together in support of this critical reform. The Family Preservation and Accountability Act represents a rare opportunity to unite during a time of such political division around a shared commitment to protecting children, strengthening families and promoting public safety. This is not a partisan issue — it's a Kentucky issue. By addressing the root causes of crime and investing in practical solutions like therapy, parenting classes and workforce development, we can create a justice system that reflects the values of accountability, compassion and rehabilitation. Together, we can build a future where families stay together, communities thrive and Kentucky's economy grows stronger.
Yahoo
28-01-2025
- Politics
- Yahoo
New Bill Would Let Landowners Sell Their Big-Game Tags for a Profit in Wyoming
In Wyoming, landowners receive big-game hunting tags to help maintain wildlife habitat and wildlife managment goals on their property. That's nothing new. What is new is what they might be able to do with those tags if an introduced bill passes the state legislature. Senate Bill 118, which is being spearheaded by a newly elected legislator, aims to make those tags transferrable, meaning landowners could sell them to whoever they wanted. 'This is a step too far,' Wyoming Wildlife Federation government affairs director Jess Johnson told Outdoor Life Monday during a break between legislative sessions. 'This is a step in the wrong cultural direction for sportsmen. We cannot let this go through.' Under Wyoming's current allocation system, landowners are eligible for a pair of draw-only tags — including two each for elk, deer, pronghorn, and turkey — for every 160 acres they own. This 160-acre minimum was also the standard used for Western homesteaders in the late 1800s under the Homestead Act, so it's still a common parcel size today. Those landowners must also prove that wildlife inhabit and utilize their properties. For a wild herd of elk, that amounts to a minimum of 500 elk on the property for at least four days a year. Legislators who support the bill (some of whom are large landowners themselves) say that making tags transferrable can help ranchers diversify their income streams during tough times. The current bill does not mention any caps on the amount those tags could go for. 'Ranchers are hurting right now,' Laura Pearson, a Wyoming Senator and sheep rancher based in Kemmerer, told WyoFile. 'It'd give ranchers and farmers the ability to sell or give those tags to whomever we want.' Read Next: Film: Public-Land Elk Hunters and Ranchers Can Be Good Neighbors. Here's How In an interview with Cowboy State Daily, executive vice president of Wyoming Stock Growers Association Jim Magnana said the group supports the idea of giving landowners more options for their tags. 'But it's a complex issue,' he acknowledged. 'And there needs to be some work on the details.' The bill in its current form designates Wyoming Game and Fish Commission as the governing entity for the new landowner tag resale program. But Johnson said that in a surprise move on Jan. 23, the bill hopped committees, moving from the Travel, Recreation, Wildlife and Cultural Resources Committee to the Agriculture, State and Public Lands and Water Resources Committee. 'I'm incredibly worried about it. Most of the time our wildlife and hunting bills go through our Wildlife Committee, but this bill was re-routed to ag,' Johnson explained. 'I hope landowners with tags in the legislature recuse themselves from the vote because it is such a conflict of interest. If this passes there will be areas in this state that go almost entirely to landowners [with no limited draw tags left for the public.]' The proposed legislation also comes amid a larger push for transferrable landowner tags in the West and other states. This worries everyday hunters, who say the practice is essentially privatizing the public's wildlife. They point to a state like New Mexico, where elk tags are sold by landowners to the highest bidders and can fetch up to $12,000, as proof of their concerns. And they say the recent Senate bill in Wyoming is an attempt to drive a wedge between the two most vocal, and sizable, constituencies in the Cowboy State. Read Next: Report Finds That New Mexico's Elk Licensing System Favors Wealthy Landowners and Out-of-Staters Over Residents 'Most of the time agriculture and sportsmen get along really well. Sportsmen know ag helps the creatures we love here,' Johnson said. 'That said, landowner tag transfer is such a decisive issue here that many in ag also view it as an issue that further separates sportsmen from ag in a time when we are trying to make sure our working landscapes continue in the future.' The Wyoming Game and Fish Department issued 3,507 landowner licenses statewide last year at $39 apiece, according to a fiscal note accompanying the bill, which doesn't mention for which species or how many applications WGFD received. But Johnson says that if the bill passes, that number is likely to go way up. 'A lot of landowners don't hunt, but if you put a monetary value on this, that's going to incentivize landowners to put in.'
