Blog
What is changing, and what to do about it.
Short, sourced write-ups of the changes in Medicare and 340B rules that hospitals ask us about, with the dates and the links to the primary reporting.
Nov 8, 2026 · Iron Horse Analytics
Medicare Will Pay 28% Below Average Sales Price for 340B Drugs in 2027
CMS finalized a cut from ASP plus 6% to ASP minus 28% for 340B drugs, a 34-point drop. What changed, who gains and loses, and what else is pending.
Nov 7, 2026 · Iron Horse Analytics
Medicare Bad Debt: What Hospitals Actually Report, 2015 to 2025
Medicare bad debt as a share of billed cost sharing, from 70,779 cost reports. Our 15% rule of thumb no longer fits, and state Medicaid policy shapes it.
Oct 30, 2026 · Iron Horse Analytics
Judge denies Michigan hospital’s bid to restore 340B drug discounts, but calls the legal question “close”
A federal judge refused to restore a Michigan hospital's 340B status for lack of irreparable harm, yet called HRSA's power to delay access a close question.
Oct 28, 2026 · Iron Horse Analytics
340B in Late 2026: What Hospitals Should Watch
On January 1, 2027, 340B hospitals start paying full price for 21 drugs and waiting for rebates. What changed in October and what to do before launch.