The Trump administration is slowing down its plan to hold back money from community health centers unless they change their patient billing practices under the 340B drug discount program.
The administration was going to finalize the rule without going through a standard notice and comment period. But HHS on Thursday published it as a proposed rule, signaling the rule will go through the usual rulemaking process. Community health centers and other stakeholders will be able to comment on the proposed rule, and HHS will review the comments before it issues a final rule.
"There seems to be growing recognition among leaders in the administration that this rule will do more harm than good at a time when too many people are suffering," National Association of Community Health Centers CEO Tom Van Coverden said in a statement. "We hope that this is further acknowledgment that a pandemic is no time to destabilize the safety net. Certainly, the high cost of prescriptions remains a national crisis — but health centers are the solution — not the problem."
A bipartisan group of lawmakers sent a letter to HHS Secretary Alex Azar last week, urging the administration to not move forward with the rule, claiming it would limit access for medically underserved patients.
"Every program has costs associated with administering and dispensing prescription drugs. The 340B program is no exception," the letter said.
President Donald Trump signed an executive order in July, targeting drug discounts that Federally Qualified Health Centers receive and reinvest in community services. The executive order proposed withholding future grant funds from community clinics unless they charge low-income patients the acquisition price for insulin and Epi-Pens, plus an administration fee. The policy caught FQHCs off-guard because most experts think hospitals, not community clinics, are improperly benefiting from the 340B program.
HHS believes the rule would have minimal economic impacts on health centers because it would only apply to two drugs available at significantly discounted prices, the agency said in the proposed rule.
The regulation was originally put forward as an "interim final rule," meaning it would go into effect as soon as HHS published it. An agency can ask for comments after publishing an interim final rule and update the rule in response to the comments it receives, but it doesn't have to do either.