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Montgomery, Alabama-based Baptist Health is suing major insurer Humana over alleged Medicare Advantage underpayments for outpatient drugs purchased through the 340B program. The hospital claims that reimbursements for the drugs were determined by a payment model that is no longer valid, and that the mounting underpayments amount to a “windfall” for the insurer.

Beneficiaries with Medicare Part D are poised to reap significant savings with the implementation of a $2,000 out-of-pocket spending cap for prescription drugs covered under the program, which is slated to take effect in 2025. This provision, signed into law as part of 2022’s Inflation Reduction Act, aims to alleviate financial burdens for millions of […]

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