[{"_1":2,"_86":-5,"_87":-5},"loaderData",{"_3":4,"_26":27},"root",{"_5":6,"_17":10,"_18":19,"_20":21,"_22":10,"_23":-5,"_24":-5,"_25":10},"user",{"_7":8,"_9":10,"_11":10,"_12":-5,"_13":-5,"_14":15,"_16":-5},"roles",[],"isAuthenticated",false,"isPremium","planName","subscriptionStatus","featureFlags",{},"insightsBudget","isDevelopmentHost","userPreferences",{},"recaptchaSiteKey","6LcvOJcUAAAAAHsB-gPGfGktcRlKpH7OTIU_dMTD","isImpersonating","impersonation","affiliateStatus","isFreedomPortal","routes/v2/article/layout",{"_28":29,"_30":31},"notFound",true,"relatedArticles",[32,74],{"_33":34,"_35":36,"_37":38,"_39":40,"_41":42,"_43":44,"_45":44,"_46":47,"_48":49,"_50":51,"_52":53,"_54":55,"_56":57,"_58":59,"_60":61,"_62":63,"_64":65,"_66":67,"_68":69,"_70":71,"_72":55,"_73":55},"mediaId",6307563,"mediaKeyId","2430675-b580a10fafaf3aca655cca5cffdaab8c","parentId",2430675,"title","Hospitals, clinics and insurers disagree on 340B fixes as Vermont considers H.266","audioSeconds",0,"startMs",2244000,"endMs","viewUrl","/Search/View?dp=1&key=2430675-b580a10fafaf3aca655cca5cffdaab8c&start=2244&end=2244","thumbnailUrl","https://assets.pipeline.soar.com/2430675-b580a10fafaf3aca655cca5cffdaab8c/thumbnail_2244000.jpg","articleUrl","/articles/6307563/Vermont/Hospitals-clinics-and-insurers-disagree-on-340B-fixes-as-Vermont-considers-H266","mediaUrl","https://secure.pipeline.soar.com/6307563-e2124311981afad5976b76961f9ba154/orig.mp4?Expires=1773683506&Signature=DW6lZGeyj~sVWuCGwVB4xud-HqVe-e6hTcbPxO2sguUI908lEOyA99T5YVwn9~lx~1t1cIS-OSFHOI9xIrKhl9BafRHPuQLx2EZ4fSpVZvUmGxDa6axKMDQ3Izw8ysfB4hynojOeETKpzubPYrS9B1zQEqY3bNKK4uAi-43rUHCsIRt4l0mzzV--Fptwb-kGz3nNGVaxWEU1UxipSS5IIC~LEPf0qM571IEbAEOmQFqGI0JwlUAl8j-Wml~704xeULDUy3z~orQcdBRePEen~exulQSNkWw~k5sI4YOZdnxtB~Laqj1q~Ga5jUVbBYc~9ZzeFbsu0kVNWQyN2zxEQg__&Key-Pair-Id=KUT5TJCACFTXG","author","","date","2025-02-27T14:05:56Z","article","Lawmakers heard competing testimony on H.266, a bill aimed at preserving access to federal 340B drug discounts for covered entities, including hospitals and federally qualified health centers (FQHCs). Hospital and clinic leaders said manufacturer restrictions on 340B contract pharmacies have sharply reduced revenue and forced difficult program and rate decisions; insurer representatives urged the committee to remove provisions that would impose new reporting or liability requirements on health plans.

Jordan Esty, director of government affairs for MVP Health Care, told the committee that insurers are not party to the 340B program and generally cannot determine from claims whether a drug was acquired under 340B. “This is a manufacturer and a provider program,” Esty said, adding that insurers do not have access to purchase-discount information and that proposed lawsuit or “interference” provisions aimed at insurers could create unintended legal exposure.

Hospital witnesses described steep revenue losses after manufacturers limited contract-pharmacy access. Jonathan Reynolds, vice president of clinical operations at Rutland Regional Medical Center, said manufacturer restrictions caused immediate financial pressure that contributed to a 2 percentage-point increase the hospital sought in a recent commercial rate request; he estimated the hospital’s annual 340B revenue loss at $8 million to $9 million and said those funds help cover underpayment from Medicare and Medicaid for inpatient and outpatient services.

Jeff McKee, CEO of Community Health Centers of Burlington (CHC), described a parallel effect at FQHCs: contract pharmacy revenue peaked in fiscal 2022 and has declined since; CHC projected about a $1.8 million decline in 340B revenue for fiscal 2025. McKee said 340B revenue goes into general operating budgets and supports outreach, behavioral-health and primary-care services and that without it many thin-margin services and rural outreach programs would be financially unsustainable. “Without 340B, contract pharmacy revenue, we have a loss going back every year,” McKee said.

Witnesses stressed a technical distinction regulators and lawmakers should note: “mixed-use” 340B drugs dispensed from a covered entity’s pharmacy to patients in clinics or infusion centers are distinct from contract-pharmacy fills (drugs dispensed at retail or mail-order pharmacies). Several witnesses asked the committee to ensure H.266’s language focuses on contract-pharmacy restrictions by manufacturers, which they said were the principal cause of recent revenue declines.

Rutland Regional and CHC urged reasonable transparency measures but warned against patient-notification rules that would simply produce confusion. Rutland Regional said its 340B reductions forced a temporary increase in a commercial rate filing and that restored contract-pharmacy access would permit lower future rate requests. Community clinics and Planned Parenthood of Northern New England said they depend on 340B pricing for contraceptive supplies and sliding-fee services; Jessica Barbas of Planned Parenthood said the organization can procure certain intrauterine devices for about $100 under 340B pricing compared with a manufacturer list price near $981 and that preserving 340B is essential to keeping services affordable.

Esty suggested the committee consider focusing legislation on manufacturer conduct and urged more study of outpatient drug pricing trends before imposing insurer-specific obligations. He pointed to transparency proposals and potential Green Mountain Care Board study as less disruptive alternatives.

Lawmakers asked witnesses to provide written summaries and data. The committee paused for a scheduled break after the testimony; no formal action or vote occurred during the hearing.","mediaType","Video","parentTitle","House Healthcare - 2025-02-27 -9:00AM","oneSentenceSummary","Testimony on H.266 centered on manufacturers’ restrictions to the federal 340B program. Hospitals and community health centers said lost 340B revenue forced service cuts and higher commercial rate requests; insurers warned that bill language imposing insurer reporting or liability risks would be counterproductive.","taxTitle","Health Care, HOUSE OF REPRESENTATIVES, Committees, Legislative , Vermont","taxId",30956,"location","Vermont","headline","shortSummary",{"_33":75,"_35":36,"_37":38,"_39":76,"_41":77,"_43":78,"_45":79,"_46":80,"_48":81,"_50":82,"_52":83,"_54":55,"_56":57,"_58":84,"_60":61,"_62":63,"_64":85,"_66":67,"_68":69,"_70":71,"_72":55,"_73":55},6307568,"UVM cancer center leaders ask Vermont for $1 million to support NCI designation bid",1603,648000,2251000,"/Search/View?dp=1&key=2430675-b580a10fafaf3aca655cca5cffdaab8c&start=648&end=2251","https://assets.pipeline.soar.com/2430675-b580a10fafaf3aca655cca5cffdaab8c/thumbnail_648000.jpg","/articles/6307568/Vermont/UVM-cancer-center-leaders-ask-Vermont-for-1-million-to-support-NCI-designation-bid","https://secure.pipeline.soar.com/6307568-5aada901fb1f0286cce68fc364543bc1/orig.mp4?Expires=1773683506&Signature=brXlV3rHo-tifsPJVpeIrzNI2m-heiEAeXdIA6DAIsGsjfZAvfR7lguYFaL-OhbfqnptKxrdXIa9roG0qBL4krrQIucQMuTxvekxghJXFeuG2bOFVbvO6uWrADjkF8ZR6s3veRUkwUs7CzHQ15cruuX7lS1ISzNrNWTorP1Ir9wjb~VTL6rMzT9fp4wd6nFxXh9YIO0IpRbHdxxlSMZ8Y0gOkiiU3HnZJPs3nXblZtdZQcNZTUgWDTHVyCcwVf3VABwn4yy2lG5tvGmW-nFplj~i7a8-2ucL68lF9gzZRxsjB2IQrprSPvYfZwB13N7Ydguf5r0ECOilInsTTjg9rA__&Key-Pair-Id=KUT5TJCACFTXG","Rick Page, dean of the Larner College of Medicine at the University of Vermont, and Dr. Randy Holcomb, director of the Vermont Cancer Initiative, told the House Committee on Health Care that the university is asking the state for $1 million a year to help secure National Cancer Institute (NCI) designation.

Page said the designation matters because of the “excellence that this represents and the opportunities that it offers,” and he urged lawmakers to support the center’s application, planned for submission in fall 2026. The university and UVM Health Network have already provided substantial internal funding, Page said, but state support would demonstrate a broader commitment the NCI looks for in applications.

NCI designation signals sustained research, education, community outreach and clinical-care capacity, the presenters said. Dr. Holcomb described four pillars guiding the center’s work—research, education, outreach and clinical care—and highlighted recent advances: research on melanoma, recruitment of faculty studying the microbiome and engineered bacteria for cancer detection, a trial using circulating tumor DNA to tailor adjuvant colon-cancer chemotherapy, and outreach aimed at increasing screening in rural counties.

Holcomb said the center brings extramural research funding of roughly $20 million to $25 million annually and cited a commonly used economic estimate that every extramural grant dollar can have a 2.5x multiplier; using that framework he estimated a potential economic impact of about $60 million for Vermont. He also pointed to program-level results: a statewide effort to increase lung cancer screening has raised screening rates by 33 percent and the center is expanding recruitment and training efforts for oncology specialists who will practice in rural communities.

Specific proposals the presenters described to lawmakers included expanding a rural oncology fellowship (the program received ACGME approval to expand and will add fellows beginning in July), a “lab on wheels” mobile science lab for rural high schools (the center has invested about $100,000–$150,000 and already secured a van), expanded primary-care support lines staffed by oncology nurse practitioners, and tele-nutrition services to supplement a statewide shortfall of dietitians (the presenters said there are about 2.4 dietitians supporting ambulatory cancer patients relative to approximately 5,000 new cancer cases annually).

Page and Holcomb sought a $1 million annual state appropriation. Page said that last year the center requested $5 million per year for five years; some committees advanced a $1 million figure but it did not appear in the governor’s budget. “A cancer center designation will have a positive impact on every resident in the state who might be at risk of or have cancer,” Page said, adding that designation would also help recruit and retain physicians across Vermont.

Lawmakers asked about how much the state must contribute to influence an NCI decision. Holcomb and Page said there is no fixed statutory dollar that guarantees designation and that other states commit widely varying amounts; Page noted large states may contribute $20 million annually while smaller states typically commit less. They said the NCI evaluates the totality of institutional, system and state support rather than a single threshold number.

Committee members asked about palliative and hospice care integration, access and appointment wait times. Holcomb said patients known to have cancer are typically seen in the center’s clinics within two weeks and described an upfront navigation program that schedules necessary testing so treatment decisions can proceed without delay. The presenters said palliative-care clinicians co-manage many patients with oncologists and that the team tracks hospice enrollment timing as a quality measure.

The presenters requested legislative consideration of the $1 million appropriation to strengthen the center’s NCI application, expand statewide programs and sustain services that target rural counties. They said the UVM Health Network and the Larner College of Medicine already provide major institutional support and that state funding would be additive and signal long-term commitment to the NCI.

The committee followed with questions; the presenters said they would provide written materials summarizing the proposal and program details.","University of Vermont leaders told the House Committee on Health Care that state support of $1 million a year would strengthen an application for National Cancer Institute designation and expand clinical, research and outreach programs across Vermont.","actionData","errors"]

Article not found

Hospitals, clinics and insurers disagree on 340B fixes as Vermont considers H.266

UVM cancer center leaders ask Vermont for $1 million to support NCI designation bid