Some North Carolina hospitals used a program called the “Federal Safety-Net 340B Drug Pricing Program” to “enrich themselves rather than to serve vulnerable communities,” according to a press release sent out on Tuesday, May 7 by NC State Treasurer Dale Folwell.
Folwell announced that he’s holding a press conference at 10:30 a.m. on Wednesday, May 8, to provide details about what he says is obvious misconduct in the medical community.
The 340B Program was set up to help safety-net providers offer service to low-income patients and rural communities. However, according to Folwell, the program has become “the second-largest federal prescription drug program in the nation.“
Under that program, hospitals can buy most outpatient drugs with an average 35 percent discount from drug manufacturers.
Despite that, 340B hospitals have no legal obligation to pass those discounts on to their patients or to invest the savings in care for vulnerable communities.
Folwell wants to see that law changed.
Folwell, who will release an extensive report on his findings Wednesday morning, stated that 340B hospitals charged state employees “massive markups” for oncology drugs.
That meant that state hospitals generated oversized profits per claim on cancer drugs paid for by the North Carolina State Health Plan for teachers and state employees.
Folwell is calling for state and federal lawmakers to reform the drug pricing program by increasing transparency and accountability. He’s also urging state lawmakers to secure hospital price relief for cancer patients, state employees and others in the state.
Folwell invited researchers to analyze State Health Plan medical claims data on outpatient oncology infusion drugs as part of the broader Hospital Transparency Project – and those researchers found that North Carolina hospitals pursued “greater profits at the expense of vulnerable communities and impoverished patients.”
According to Folwell, state hospitals neglected to respect the clear intent of the 340B program.
We are being “balanced billed” by a local Hospital chain for drugs administered as a patient in their hospital. We have met our max OOP for the year, and we still get four-figure bills….and past due notices.
I saw this same practice years ago at another Hospital.
Local & regional hospitals buy out independent practices because they can (independents are awash is regulations, taxes, and expenses). Then we are billed at hospital-like prices for routine visits & tests.
This is Big Business in operation.
Since these bigger medical groups are beholden to the US government, because Medicaid and Medicare account for a major portion of their income, they try to maximize their profits. They charge higher than reasonable prices knowing the government will only pay a certain percentage, and 9ne can assume there are cost cutting measures being taken everyday. I applaud Mr. Folwell’s attempt, especially in an election year, but I assure you the hospital and medical lobbyists are burning the midnight oil to keep any substantive action from being taken.
A snark moment.
Medicare benefits are based on Medicare-allowed charges, not “reasonable”. Medical providers who accept Medicare patients agree to accept the allowed charge as full payment. Balance billing is nefarious at best, and just downright sneaky; the provider hopes you will pay it. Depending on your type of Medicare insurance, there are fixed allowed charges OOP expenses before you reach your max OOP.
When my mother-in-law passed away a while back, she got a bill for some $3,000+ from Baptist. She had original medicare and the best Supplement. When I called the Hospital with this info, they said they would call back – they never did.
The best insurance is original Medicare (your red/white/blue card), and Supplement of your choice, plan G is the best. Check your Medicare book to see who has the best coverage for your RXs. Avoid Humana. Medicare Advantage is a misnomer – it is your worst choice. It’s cheaper, until you get sick. How do I know? Many years on Medicare, other people’s experience, and insurance people in the family.
I’m shocked…shocked to hear this (snark off)
Snark on, snark off…..
Big business it is, Miller! Anyone who has been admitted to the hospital and is on prescription drugs knows that the hospital won’t allow anyone to dispense the drugs you have at home, they’ll charge you an inflated price and distribute their drugs.
Each patient is a profit center, and if anyone out there thinks Government Health Care is the route to go I suggest you get your head examined (by an in-network Doctor of course).
I experienced this first hand a Wesley Long Cone Hospital during a recent surgery, I am diabetic, I take a drug named, Januvia, I asked to bring my script with me as this drug is very costly, the admissions nurse said no, I am waiting to see my bill, you can bet they jacked the price sky high.
My last visit for knee replacement, I brought my RXs with me, and insisted on it. They left me alone. The staff were incompetent, inattentive, a just plain lazy – you know who they are. They hire the cheapest help they can find. Since then, we avoid this local Hospital if possible.
The medical-pharmaceutical complex is NOT on our side.
– and Obamacare made it worse. Why do you think all the insurance companies were in favor of it?
How did Obamacare make it worse?