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How to Address Discriminatory Reimbursement

In response to accelerations in discriminatory reimbursement, many states are taking action to protect the 340B drug pricing program through state legislation. Read on to learn more about what actions lawmakers are taking in Tennessee.
What is discriminatory reimbursement?
Discriminatory reimbursement occurs when third parties keep savings from the 340B program that are intended to benefit community health centers, and other covered entities. 

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Why is legislation needed to address discriminatory reimbursement?
Federal and state statute do not prohibit the practice of discriminatory reimbursement from third parties such as Pharmacy Benefit Managers (PBMs), insurers, and contract pharmacies. Third parties can retain savings from the program that are intended to benefit community health centers and other covered entities. 
 
Is there currently legislation to address discriminatory reimbursement?
Yes, SB1206/HB1349, sponsored by Senator Briggs and Representative Helton and SB1617/HB1398 sponsored by Senator Reeves and Representative Helton would prohibit discriminatory reimbursement in Tennessee. 
 
How does the state legislation fix the problem?
Each of these bills would prevent third parties from:
  • Reimbursing a 340B entity less for drugs than a non-340B entity
  • Assessing fees on 340B entities that are not also applied to non-340B entities
  • Excluding 340B entities from networks of pharmacies based on criteria that is not also applied to non-340B entities
 
What can you do to support the 340B program?
Reach out to your members of the TN General Assembly and ask them to support SB1206/HB1349 and SB1617/HB1398 to ensure community health centers and other 340B covered entities can utilize savings from the 340B program to provide care to vulnerable and underserved patients.

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