Comment on DOD-2008-HA-0029-DRAFT-0016

Dear Admiral McGinnis: In the attached document, Safety Net Hospitals for Pharmaceutical Access (SNHPA) takes the opportunity afforded by the extended comment period on manufacturer discounts/rebates under the TRICARE Retail Pharmacy Program to express our concerns that the program appears to be discriminating against 340B health care providers. This discrimination is apparently occurring because of a provision of 32 CFR Part 199 that exempts 340B drugs from TRICARE manufacturer discounts/rebates. We write to ask that TRICARE and the Department of Defense affirm that it is not your intent to exclude 340B providers from participation in the TRICARE Retail Pharmacy Program provider network or to discriminate against 340B providers, but only to exclude their drugs from manufacturer rebates/discounts. SNHPA is a trade association representing more than 500 safety net hospitals that participate in the federal 340B drug discount program. Our association is a member of the larger 340B Coalition, an organization of 11 provider groups that represent thousands of safety net providers and programs participating in the 340B program. The Coalition includes – besides our own disproportionate share and children’s hospitals – federally qualified health centers (FQHCs), hemophilia treatment centers, Ryan White AIDS Centers, family planning centers, and rural health providers. We hope you agree with us that, for the sake of the health and safety of their patients, it is important that 340B providers not be discriminated against, nor excluded from the TRICARE Retail Pharmacy Program provider network. We hope that TRICARE and DOD will address this matter expeditiously by halting ongoing conduct which is having a discriminatory effect. If you have any questions, please feel free to contact me at 202-552-5851 or stuart.gordon@snhpa.org. Thank you for your attention to this crucial issue. /s/ Stuart Yael Gordon Director, Legal and Regulatory Affairs SNHPA