[{"_1":2,"_100":-5,"_101":-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",[32,76,88],{"_33":34,"_35":36,"_37":38,"_39":40,"_41":42,"_43":44,"_45":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,"_73":74,"_75":74},"mediaId",6455497,"mediaKeyId","5836678-a59010dafed3a37002571b71e8a9867d","parentId",5836678,"title","Hospitals, pharmacists and clinics say manufacturer limits on contract pharmacies are stranding rural patients","audioSeconds",408,"startMs",14037000,"endMs",14445000,"viewUrl","/Search/View?dp=1&key=5836678-a59010dafed3a37002571b71e8a9867d&start=14037&end=14445","thumbnailUrl","https://assets.pipeline.soar.com/5836678-a59010dafed3a37002571b71e8a9867d/thumbnail_14037000.jpg","articleUrl","/articles/6455497/Kansas/Hospitals-pharmacists-and-clinics-say-manufacturer-limits-on-contract-pharmacies-are-stranding-rural-patients","mediaUrl","https://secure.pipeline.soar.com/6455497-31042f918c1cbf12ac0f271c30b59501/orig.mp4?Expires=1770491384&Signature=jxT~gX0xANXM201tXfGd-hLNL6lVH~yrUH7lhbtgGzlQJh91OmcRmnXeFFaeV8RP76xMeRQo2V9tiunTXaihhGrt2z7txtE0H0Tyl707L-rvz3FbncHZglh4TS3p1HBnUadWuTxy6S~s0SdSNmP~vtE3AoGI-9NfQH4wgk8mGfESSOg9gUUXrcuF7DFppoTNV8Idyrg2pkVOY9x9e9TTSiLTi85IM6Ass~q1ZmfLie4DOp1LJbv-fTr9e53ON0Y5KnYUvuERTXIifetx02pZJrjSfSjH1AyTiKT5Q1jNGdF~lbCgs2vHVzm8v4ohPP~LfWDV58Wku9aajA6PkH7RtA__&Key-Pair-Id=KUT5TJCACFTXG","author","Kansas Legislature","date","2025-09-26T20:29:55.337Z","article","TOPEKA, Kan. — Hospital leaders, community pharmacists and medical‑clinic directors testified Oct. 25 that manufacturer limits on where 340B‑discounted drugs may be dispensed are complicating care in rural Kansas and, in some cases, forcing patients to travel farther to pick up medicines.

“We have our own pharmacy, but we also contract with local independent pharmacies so patients can get medication closer to home,” said Matthew Schmidt, chief executive of Health Ministries Clinic in Harvey County. “When manufacturers restrict contract pharmacies, patients can lose local access.”

Why it matters: Contract pharmacies historically have allowed covered entities to dispense 340B medicines through off‑site locations. Witnesses described manufacturer actions that limit which pharmacies may be used for 340B fills, and they said the limits sometimes block the local pharmacy where a patient normally fills prescriptions.

Local examples: Paul Shiffrell, a pharmacist who operates Citizens Medical Center’s 340B program and consults for other critical‑access hospitals, described a patient who avoided painful injections after staff used a 340B discount to supply a $600 outpatient drug for $10. Shiffrell said the saving came through the hospital’s 340B program and enabled a less burdensome treatment plan. He and other pharmacists said manufacturers’ restrictions on contract pharmacies have interrupted similar programs in other Kansas towns.

“We set up a cash‑card program to pass savings directly to patients. When manufacturers limit contract pharmacies that option can disappear,” Shiffrell said. He added that many small hospitals use 340B revenue to subsidize services that otherwise run at a loss.

Hospitals’ perspective: Brian Anderson, CEO of Prairie Star Health Center in Hutchinson, said hospital leaders ask only that states protect existing contract pharmacy arrangements so safety‑net providers can preserve access. “Kansas safety‑net providers are simply asking for 340B contract pharmacy arrangement protections requiring drug manufacturers to ship 340B drugs to contract pharmacies without conditions,” Anderson said.

Pharmacists’ perspective: Pharmacists said the impact is not just theoretical. “We’ve had to designate a single in‑town pharmacy to receive 340B fills; when patients go to the other independent pharmacy they lose the discount unless they transfer their prescription,” said Paul Shiffrell. Independent pharmacy owners warned that low reimbursement and opaque contract terms threaten the viability of standalone pharmacies that many rural residents rely on.

Manufacturers and industry view: PhRMA and industry witnesses told the committee the program needs federal rules and better reporting to ensure discounts reach patients and to limit practices that could increase costs for employers and taxpayers. Caitlin Lucarello of PhRMA said expanding contract‑pharmacy networks is not the only answer and noted litigation challenging state mandates that would force manufacturers to sell to unlimited contract pharmacies.

What lawmakers heard: Committee members pressed witnesses about data showing charity care levels, hospital revenue sources and whether contract‑pharmacy restrictions were intended to limit patient access. Witnesses for hospitals and clinics argued the limitations often reduce access and sometimes force patients to travel 30–60 minutes for outpatient drugs. Witnesses representing manufacturers and some federal‑policy organizations argued the primary need is federal transparency and contract tweaks to guard against misuse.

What did not happen: The session was informational and produced no legislative action. Several committee members requested additional Kansas‑specific data on 340B flows and the number and location of contract pharmacies serving Kansas hospitals.

Ending: Hospital and clinic leaders left the committee with a clear request: state‑level protections for existing contract pharmacy arrangements and better public reporting on how 340B revenues are used in Kansas.","mediaType","Video","parentTitle","Special Committee on Pharmaceutical Studies 09/26/2025","oneSentenceSummary","Hospital leaders, community pharmacists and clinic directors told a Kansas committee that manufacturer restrictions on where 340B‑discounted drugs may be dispensed are reducing access in rural areas and complicating operations.","taxTitle","Senate, Committees, Legislative, Kansas","taxId",15103,"location","Kansas","headline","","shortSummary",{"_33":77,"_35":36,"_37":38,"_39":78,"_41":79,"_43":80,"_45":81,"_47":82,"_49":83,"_51":84,"_53":85,"_55":56,"_57":58,"_59":86,"_61":62,"_63":64,"_65":87,"_67":68,"_69":70,"_71":72,"_73":74,"_75":74},6455501,"Kansas hearing lays out how 340B grew and why federal reform and transparency are back on the agenda",1874,224000,2098000,"/Search/View?dp=1&key=5836678-a59010dafed3a37002571b71e8a9867d&start=224&end=2098","https://assets.pipeline.soar.com/5836678-a59010dafed3a37002571b71e8a9867d/thumbnail_224000.jpg","/articles/6455501/Kansas/Kansas-hearing-lays-out-how-340B-grew-and-why-federal-reform-and-transparency-are-back-on-the-agenda","https://secure.pipeline.soar.com/6455501-98f59eb7842bb587abbd3a07b084e0c2/orig.mp4?Expires=1770491384&Signature=NHhSaomxSP~WgE7W80VEZ1hkRH~Uo8z5Xd6WNt6i~4Q3ZGUmeKrZucOhMcDfJL~s~Y1rASI4rmEdAzHhCs~l94pzXIKl7ZfO9KIS2tsY-5vlpkQ4AahECUwZsrcBhTy6TokKt2tDw3n7u4nY1mPKevHa3aivkfgMUtZZhzDhxehABHUmNOQaFThHxby9g53apik~4iY~xsgAqV6HvzlX--1iKH9zqZBeAuDgnvKadDBPaNAOqMZmQzBvNNDxQCeNcFaxpNUmXN2jyi0d5YhLIIcYSlqi7JgvdTGhjpFYEx492knLFRQARz3zBYvTX7vjZ-HhIOam8giUEpONZGkRSw__&Key-Pair-Id=KUT5TJCACFTXG","TOPEKA, Kan. — Lawmakers on a Kansas special committee on Oct. 25 heard competing views on how the federal 340B drug-pricing program has expanded since 1992 and whether Congress should act to require more transparency and protect the program’s original safety‑net purpose.

The hearing brought policy analysts, hospital and clinic leaders, pharmacists, employer representatives and advocates to explain how 340B discounts are generated and distributed and to describe federal bills and pilot programs now under discussion in Washington.

“The 340B program has had a profound impact on the landscape of American health care,” Jackson Hammond, senior policy analyst at Paragon Health Institute, told the committee. “The impacts include increased consolidation, higher drug prices, and increased health insurance premiums.”

Why it matters: 340B requires drug manufacturers to sell outpatient medicines at discounted prices to qualifying safety‑net providers, a mechanism intended to help hospitals and clinics stretch federal resources for uninsured and low‑income patients. Witnesses said the program has become much larger than Congress anticipated, producing both benefits for some providers and concerns about growth, opaque revenue flows and downstream cost effects for employers and taxpayers.

Who testified: The committee heard a historical summary from Hammond and a review of national data from Dr. Robert Popovian of the Pioneer Institute. Industry and trade witnesses — including a representative from PhRMA, Caitlin Lucarello — urged federal fixes built around transparency and guardrails. Employer and purchaser groups asked for clearer data showing how 340B discounts affect private health plan costs.

How the program grew: Hammond told lawmakers that 340B began after the 1990 Medicaid Drug Rebate Program established a “best price” rule and that Section 340B of the Public Health Service Act was intended to let qualifying entities obtain lower outpatient drug prices. He said the program expanded from fewer than 100 hospitals in the early 1990s to nearly 3,000 hospitals and more than 14,000 covered entities by 2024, with 340B‑eligible drug purchases rising from roughly $2.4 billion in 2005 to more than $66 billion by 2023.

“The increase in 340B participation was driven by several factors, including off‑site clinic growth, Affordable Care Act changes, and the rise of contract pharmacies,” Hammond said. He added that the program’s growth has raised questions about consolidation — hospitals acquiring physician practices and clinics — and that the program now touches many parts of the pharmaceutical supply chain.

Federal activity and pilots: Witnesses described several concurrent federal efforts. Hammond and others referenced bills and working groups in Congress, including the proposed “Sustained 340B Act” in the Senate and House transparency proposals. The committee also heard about a Centers for Medicare & Medicaid Services pilot to test rebate models intended to reduce duplicate discounts and speed manufacturer rebates to hospitals.

Differing views on effects: Some witnesses framed 340B as essential for keeping rural and community clinics open and for funding services such as dental care, behavioral health and charity care. Others said the program’s lack of public reporting makes it impossible to know whether discounts consistently reach patients, and some studies and state reports suggest portions of 340B revenue are not tied to increased charity care.

“We are not saying the program should be abolished,” Dr. Popovian said in his testimony for the Pioneer Institute. “But 340B has grown far beyond what Congress first conceived, and states and Congress should require better reporting so policymakers can see exactly where those resources go.”

What reform could look like: Advocates for federal reform urged two broad steps: (1) greater transparency so researchers, payers and the public can trace 340B discounts and hospital revenue; and (2) rules to prevent duplicate discounts (particularly involving Medicaid) and to clarify who qualifies as a 340B patient. Several witnesses described state transparency measures already enacted in Minnesota and Indiana as models that reveal how much hospitals and contract pharmacies receive and how funds are spent.

Committee action: The hearing was informational and produced no votes. Committee members said they wanted better data and suggested continuing the conversation and exploring what state actions — short of duplicating federal law — could be useful in Kansas.

What’s next: Multiple witnesses urged lawmakers to press federal representatives for national reform because 340B is a federal program. Several also suggested that state transparency laws could give Kansas policymakers better information to protect rural hospitals while ensuring discounts benefit patients.

Ending: The committee recessed after the day’s testimony with members saying they would continue to study the issue and could propose or support direction to federal legislators if state inquiries confirm problematic revenue flows.","Lawmakers on a Kansas special committee on Oct. 25 heard competing views on how the federal 340B drug‑pricing program has expanded since 1992 and whether Congress should act to require more transparency and protect the program’s original safety‑net purpose.",{"_33":89,"_35":36,"_37":38,"_39":90,"_41":91,"_43":92,"_45":93,"_47":94,"_49":95,"_51":96,"_53":97,"_55":56,"_57":58,"_59":98,"_61":62,"_63":64,"_65":99,"_67":68,"_69":70,"_71":72,"_73":74,"_75":74},6455493,"Employers, insurers and PBMs explain competing pressures; state insurance office outlines licensure work",2115,8577000,10692000,"/Search/View?dp=1&key=5836678-a59010dafed3a37002571b71e8a9867d&start=8577&end=10692","https://assets.pipeline.soar.com/5836678-a59010dafed3a37002571b71e8a9867d/thumbnail_8577000.jpg","/articles/6455493/Kansas/Employers-insurers-and-PBMs-explain-competing-pressures-state-insurance-office-outlines-licensure-work","https://secure.pipeline.soar.com/6455493-3165f38a64473cd42c47e88463160aef/orig.mp4?Expires=1770491384&Signature=Naf-DnW8FI6qGoGsw85I5kP3ff7JLlYd11h3R7wgZ5vJqjAQU09YApettKEePivOIHEGJmfm5-3AjdKIRWWXoRoHlddVIkSMn26l~IfHWf3D28-Hu5UCAwuKPAX~mPRjw9x8dCOMlvQ8SSKBmrFkzfzILg60FoXYgkQRKgf7v9pvw0xi2X2CT3NqatGroZ5ka5Zq1NCDV7AWeSkKPmP-rzzb~e3RP5o0N505qE0rmRWsvoflraJAT8XTvpxernhPi2S5Hx~eojUlX7fZn9igbCFNxbbFUeCkzin9Dpc879Xs6X2empF~YJAMRzaqBgQIpF1G9CclrFEwYTQaqf9-rw__&Key-Pair-Id=KUT5TJCACFTXG","TOPEKA, Kan. — Business representatives, benefits administrators and state insurance officials described a mixed picture to a legislative committee on Oct. 25: employers say PBMs help manage drug costs, while employers, pharmacies and the Kansas Department of Insurance warned that opaque terms and vertical integration can distort markets and harm community pharmacies.

PBMs’ role and employers’ view: Andrew Wiens, executive director of Kansas Employers for Affordable Health Care, told the committee that employers rely on PBMs to negotiate rebates, encourage use of generics and manage formularies. “Employers use pharmacy benefit managers because they save employers money,” he said, noting that PBMs produce measurable savings for many self‑funded plans.

“PBMs save payers and patients an average of $10.40 per person per year,” Wiens said, citing industry and independent studies. He warned that state measures that lock PBMs into specific contract terms or price floors could raise employer health‑care costs by reducing contractual choice.

Pharmacists and community owners: Pharmacy owners told a different part of the story. Independent pharmacists said low fees, auditing pressure and contract terms have forced many small pharmacies to close. “The single greatest threat to our profession and to patient care is the monopolistic and anti‑competitive practices of the PBMs,” said Brian Caswell, a multi‑store owner. Witnesses argued that price setting and secret contractual terms have left some local pharmacies dispensing at a loss.

State insurance oversight and licensure: Eric Turek, director of government affairs for the Kansas Department of Insurance, described the 2023 PBM licensure law, noting the department has licensed 53 PBMs. He outlined an issue the department flagged: a statutory loophole allowing entities that are registered third‑party administrators to avoid PBM licensure in some cases. The department said it has sought legislation to close the loophole and that it receives complaints about PBM practices including spread pricing and patient steering.

State employee plan and plan design: Mike Michael, deputy director for the State Employee Health Plan, explained how Kansas’ plan works across four plan designs, how prescription coverage differs by plan, and how specialty programs operate. He said the state’s plan offers tools such as a specialty pharmacy and a manufacturer co‑pay assistance program to reduce out‑of‑pocket costs for employees.

Employer implications: Andrew Wiens and other employers said PBM reforms should preserve competitive contracting options and avoid state‑mandated price floors or forced contractual disclosures that could limit plan sponsors’ ability to design benefits. Several employer witnesses argued that small employers and unions may lack the market leverage of large plan sponsors to demand different PBM terms.

Committee response: Committee members acknowledged competing priorities — protecting community pharmacies and ensuring plan sponsors control costs — and asked the Department of Insurance for more information about PBM complaints and possible fixes to the licensure loophole.

Ending: No legislative action was taken at the hearing. Committee members asked for agency follow‑up and said they expected to return to PBM questions as they consider options to balance transparency, competition and access for Kansas patients and employers.","Kansas employers and the Department of Insurance told a legislative committee that PBMs (pharmacy benefit managers) help employers control drug spending but that opaque contracts, spread pricing and vertical integration have created market distortions. Kansas regulators described the state's PBM licensure law and a loophole affecting third‑party","actionData","errors"]

Article not found

Hospitals, pharmacists and clinics say manufacturer limits on contract pharmacies are stranding rural patients

Kansas hearing lays out how 340B grew and why federal reform and transparency are back on the agenda

Employers, insurers and PBMs explain competing pressures; state insurance office outlines licensure work