STATEMENT REGARDING GAO REPORT ON DUPLICATE DISCOUNTS
WASHINGTON, D.C.— The following statement on today’s Government Accountability Office (GAO) report on duplicate discounts is attributed to 340B Health President and CEO Maureen Testoni:
“340B hospitals strongly support the prevention of duplicate discounts and work closely with states and manufacturers to identify drug claims under both Medicaid fee-for-service and managed care that are ineligible for rebates.”
“However, the GAO’s recommendations are incompatible with the statutory roles of states, federal agencies, and covered entities to prevent duplicate discounts for drugs covered by Medicaid and 340B. The law is unambiguous in establishing that states have the responsibility to avoid collecting Medicaid rebates on 340B drugs used in Medicaid managed care. In cases where such duplicate discounts occur, it is the duty of the state to repay manufacturers. In its recent informational bulletin, the Centers for Medicare & Medicaid Services (CMS) recognized that, noting: ‘[S]tates are prohibited from billing manufacturers for Medicaid rebates for drugs dispensed to Medicaid patients that have already been discounted under the 340B Program.’”
“Yet, the GAO recommends the federal Health Resources & Services Administration (HRSA) intervene in this process by auditing hospitals and other covered entities for compliance with state Medicaid managed care rules. The report recommends that safety-net providers be the ones to repay manufacturers for duplicate discounts when states wrongly accept Medicaid drug rebates for 340B drugs. That would penalize 340B providers for a state’s failure to follow its own policies and procedures or to ensure providers are informed of the state’s policies.”
“Key aspects of the recommendations in the report are misguided, unworkable, and contrary to federal law. In addition to our own concerns, we also share the Dept. of Health and Human Services’ (HHS) disagreement with many of the GAO’s conclusions.”
Contact: Richard Sorian at richard.sorian@340bhealth.org or 202-536-2285.