Middle Country Oral Surgery

12/17/2025

I remember when the 340B program was introduced, I was a resident at the time. What began with good intent, has transformed into a program that does not help those it was established to assist. Sadly, it has turned into a slush fund that does not lower the cost of drugs, or increase access, for the poor and medically underserved.

When a safety-net program becomes a hospital cash machine | Guest column
Richmond-Times Dispatch by Justin Leventhal
12.17.25

The 340B Drug Pricing Program was originally intended to help low-income and uninsured patients afford medicine. It was created to replace the discounts and free medicines that manufacturers provided to hospitals before the 1990s. However, since its inception, it has grown — with little transparency — from a targeted program for those in need into a cash grab for hospitals. Without enforced reporting requirements and a clear focus on directing savings to the intended beneficiaries, the 340B program will remain corporate welfare for wealthy hospital systems.

The most significant shift in the program came in 2010 when HRSA issued guidance allowing hospitals to contract with multiple pharmacies under the program. Previously, they were limited to just one. This change triggered a rapid expansion, and today nearly 60% of all pharmacies in America participate in the program. Notably, the program has never required participating hospitals to provide discounted care. As a result, many offer no additional care to vulnerable patients when compared to hospitals not participating in the 340B program. Hospitals are also not required to pass any savings on to patients, which has fueled their expansion into affluent markets where they can buy discounted drugs and sell them at full price.

Fixing this program is straightforward — if Congress has the political will. First, hospitals should be required to report who receives 340B-discounted drugs and how the savings are being used. Without basic accountability, there is no incentive to ensure the program serves patients. At a minimum, hospitals should disclose how much of the discount is passed to patients and how much they retain. Second, Congress should mandate that 340B savings be passed through to each patient receiving 340B-discounted drugs. While some administrative costs are reasonable, the lion’s share of the savings should be used to make unaffordable medicines affordable — not inflate hospital margins. Third, eligibility requirements must be updated.

Affiliated satellite locations in high-income areas should be restricted, while rural hospitals should be given a clearer path to participate. The simplest solution: count uninsured patients when determining eligibility. They are the most vulnerable and often in the most need of assistance, not to mention one of the groups the 340B program was created to help. Including them in the DSH status should have been part of the program from the beginning.

The 340B program is no longer focused on serving the vulnerable — it now subsidizes hospital systems skilled at exploiting its flaws. What began as a safety net has become poorly regulated corporate welfare, with little obligation to pass savings on to patients. Without enforceable reporting, modernized eligibility rules and a mandate to deliver benefits to those in need, 340B will continue to divert public money for private gain. Congress has the tools to fix this; what’s missing is the will to put patients first.

Fix 340B now.

Senator Chuck Schumer Congressman Hakeem Jeffries Rep. Elise Stefanik U.S. Rep. Nicole Malliotakis Rep. Claudia Tenney Rep. Andrew Garbarino Congressman Nick LaLota Rep. Tom Suozzi Rep. Laura Gillen

12/04/2025

Mike Essen published an extremely informative Op-Ed in the Tampa Free Press explaining why reforming the abuses of pharmacy benefit managers would be far more effective in controlling prescription drug pricing than any price control plan such as the proposed Most Favored Nation policies. At the end of the day, we all want to see prescription medications more affordable, but we can't attack prices in a way that discourages medical research and innovation that can lead to the next treatment or cure for debilitating and deadly medical conditions.

Let's get PBM reform over the finish line THIS YEAR, our neighborhood pharmacies and American patients are depending upon it!

Senator Chuck Schumer, Congressman Hakeem Jeffries, Rep. Elise Stefanik, U.S. Rep. Nicole Malliotakis, Rep. Claudia Tenney, Rep. Andrew Garbarino, Congressman Nick LaLota , Rep. Tom Suozzi, Rep. Laura Gillen

Floridians know too well that the cost of prescription drugs can feel like a second mortgage. From seniors on fixed incomes to families helping children

11/19/2025

Stories like this are becoming the norm, not the exception. Independent and neighborhood pharmacies are under constant attack and the medically vulnerable and isolated pay the price. We need real PBM reform and we need it now. This is something we should be able to find common ground on regardless of political affiliation or ideology. With the government shutdown behind us, now is the time to focus on the health of our communities and nation.

I urge Senator Chuck Schumer, U.S. Senator Kirsten Gillibrand, Congressman Hakeem Jeffries. Rep. Elise Stefanik. U.S. Rep. Nicole Malliotakis, Rep. Claudia Tenney, Congressman Nick LaLota , Rep. Andrew Garbarino, Rep. Tom Suozzi, Rep. Laura Gillen and the entire New York Congressional delegation to work together for meaningful PBM reform THIS YEAR to protect our independent and neighborhood pharmacies and ensure access to front-line medical care and advice in our communities.

More pharmacies are disappearing from neighborhoods, including in Philadelphia. NBC10 looks into the reasons why.

10/22/2025

Seniors, and their caregivers know this time of year as that critical period when they need to choose their Medicare coverage for the coming year. For many, traditional Medicare is their tried and true choice, but they may not realize that there is another option that provides additional benefits and the ability to pick a plan that best meets their particular needs - medical and financial. These plans are known as Medicare Advantage plans.

Seniors and their caregivers owe it to themselves to take a look at the full range of options available to them - particularly their Medicare Advantage options.

Medicare Advantage Majority just released a comprehensive survey that clearly demonstrates that (1) seniors overwhelmingly love their coverage under Medicare Advantage, and (2) that Medicare Advantage supports families by providing assistance to caregivers that are sandwiched between caring for their aging parents while also working and raising their own children.

I encourage everybody who is receiving Medicare, or caring for a loved one who is, to take the time to read this informative survey as well as encourage New York's elected federal representatives to do all they can to support and grow Medicare Advantage so that New York's seniors are able to age with dignity and in health.

Senator Chuck Schumer Congressman Hakeem Jeffries U.S. Rep. Nicole Malliotakis Congressman Nick LaLota Rep. Tom Suozzi Rep. Andrew Garbarino Rep. Elise Stefanik Congressman Nick Langworthy Rep. Mike Lawler Rep. Laura Gillen

For Immediate Release: October 22, 2025 Contact: Darren Grubb, Medicare Advantage Majority Spokesperson press@medicareadvantagemajority.org WASHINGTON, D.C. – A new, first-of-its-kind national survey released […]

10/09/2025

Medicare Advantage Open Enrollment is right around the corner. MA is an invaluable program for millions of Americans, including more than 2.2 million New Yorkers. The additional benefits it provides to seniors and their care givers can make all the difference in controlling chronic medical conditions and maintaining lifestyle independence.

Cuts in funding over the years have resulted in reduced benefits that seniors depend upon as well as rising premium costs. Now, certain members of Congress are further threatening Medicare Advantage through the No Upcode Act.

Fortunately, legislators at the state and national level - from both parties - are standing up to say, "Don't do it!" They recognize how critically important Medicare Advantage to the lives of millions of Americans. We should be empowering seniors in their golden years to make the choices that help them live the best quality of life and maintain their dignity. They worked all their lives to reach this point, let's not sn**ch it away by forcing them into a one size fits no one traditional Medicare model.

Thank you Scott Bendett for speaking up for New York's seniors. Senator Chuck Schumer, Hakeem Jeffries, U.S. Rep. Nicole Malliotakis, Rep. Mike Lawler, Congressman Nick Langworthy, Rep. Tom Suozzi, Rep. Andrew Garbarino, Congressman Nick LaLota PLEASE OPPOSE the No Upcode Act to protect New York seniors' CHOICE in accessing their medical care.

by New York State Assemblyman Scott Bendett I’m deeply proud to represent my constituents in Rensselaer, Washington, Albany, and Columbia counties. And I’m fiercely protective of their wellbeing. This is especially the case when it comes to our senior citizens, who have spent a lifetime working,...

09/26/2025

Just last week I had the opportunity to join other patient advocates in a meeting with Senator Chuck Schumer's senior staff and health policy expert. It was an extremely productive meeting as patients, caregivers, and medical providers like me shared personal stories on the failings of the health care system and what can be done to improve patient access to care, patient choice, and affordability.

A number of the issues raised in this article mirror the experiences that were shared with Senator Schumer's staff. Insurance companies don't live up to their responsibilities. The fact is I have to employ an outside firm just to deal with the processing of paperwork with insurance companies. I spend an inordinate amount of time arguing with insurance companies for authorizations for procedures my patients need - taking time away from providing actual care. Pharmacy Benefit Managers force patients to take less effective or ineffective medications, a practice known as "step therapy" because those are the most profitable medications for the insurance company. And 340B hospital pharmacy programs that were designed to provide affordable access to critical medications to treat chronic medical conditions in economically disadvantaged communities have turned into slush funds for hospitals.

None of this is acceptable and it needs to change!

As health insurers have consolidated and tightened their grip on the U.S. health care system – and in particular on physician practices – doctors increasingly have to spend their days batt

09/23/2025

A number of my senior patients are telling me about expected increases in the cost of Medicare Advantage next year. Bottom line, investing in prevention by properly managing chronic medical conditions through the wealth of benefits available from Medicare Advantage plans is vastly less expensive than treating a medical crisis in the hospital setting.

Extremely rural areas are at greater risk, as are poor urban areas, where homebound seniors may not be able to get to the doctor for preventative care and rely upon in-home services.

The "No Upcode Act" before Congress puts seniors at risk. I can't be any clearer, and Long Island's Congressional Delegation MUST oppose this dangerous evisceration to senior health care.

Rep. Tom Suozzi, Rep. Andrew Garbarino, Congressman Nick LaLota , Rep. Laura Gillen, Senator Chuck Schumer, Congressman Hakeem Jeffries

We’re sounding the alarm: The No UPCODE Act will only disrupt care and affordability for seniors in Medicare Advantage. The […]

09/05/2025

It is often said there are two things you don't want to watch being made - sausage and our laws. The machinations of of legislation can be frustrating to say the least. Patients needing prescriptions shouldn't be held hostage by pharmacy benefit managers (PBMs) that put profits ahead of positive patient outcomes.

Our representatives in DC have come close a number of times, but somehow we never get to the point where these middlemen are reigned in and drugs become more affordable, patients aren't forced to go through "step therapy" with ineffective drugs, doctors and patients make decisions - not bean counters, and independent neighborhood pharmacists get a fair shake!

Politico by Calen Razor, Mia McCarthy, and Benjamin Guggenheim
09.05.25
House GOP leaders are forging ahead toward a second major domestic policy package. But hope is dwindling among Republicans that they can get it done by year’s end. Passing President Donald Trump’s first “big, beautiful bill” was already an excruciating exercise. It sparked intense policy fights among GOP factions and created huge fodder for Democratic attacks in the midterms. Sen. James Lankford told Benjamin this week he’s actively pushing Finance Chair Mike Crapo to re-up an overhaul package for pharmacy benefit managers, the intermediaries who negotiate drug prices between pharmacies and insurers. Lawmakers landed on a bipartisan deal last year, but it fell by the wayside when Elon Musk and Trump torpedoed the larger government funding package that contained it. In a wide-ranging interview Wednesday, the Oklahoma Republican said one of the biggest challenges in getting a new PBM legislative agreement is convincing the Congressional Budget Office to accurately tally how much consumers would save from various policy changes. Lankford also said he is committed to securing language in an overhaul bill that would prohibit a practice where consumers are directed to buy more expensive brand name drugs when comparable, less expensive options exist."

I'm imploring Senator Chuck Schumer, U.S. Rep. Nicole Malliotakis, Congressman Nick LaLota , Rep. Andrew Garbarino, Congressman Hakeem Jeffries, Rep. Claudia Tenney, Rep. Elise Stefanik, and all of New York's congressional delegation to deliver on PBM reform this year. Americans have waited long enough, and it is time to return sanity to the pharmacy!

08/27/2025

Sometimes the best intentions have dire consequences. The following opinion piece on drug price controls sums up well what will likely happen to innovation and accessibility if the government interferes in the market.

We MUST get drug prices under control, but we can't target those who bring them to market. Instead we need to target those who corrupt the market - i.e. pharmacy benefit managers who put their profits over your health.

Importing foreign price controls won’t lower drug prices
Washington Examiner by Nicholas Armstrong
08.27.25
Complex problems are rarely solved by a simple stroke of a pen. President Donald Trump‘s proposal to enact a most-favored-nation policy for drug pricing in the United States will do more harm than good. Trump is correct to seek to lower drug prices, as the U.S. has the world’s highest drug prices compared to other developed countries. But enacting price controls will leave Americans with fewer choices without addressing the actors responsible for high drug prices in the U.S. Trump’s most favored nation policy is simple: It ties drug prices paid by Medicaid and Medicare to the lowest price paid by other developed nations such as the United Kingdom, Canada, or Germany. If patients in other developed countries pay lower prices for drugs, then Americans should pay those lower prices as well. While this seems like a good idea at first glance, it ignores a number of complexities and basic economic realities. MFN agreements are price ceilings that set a maximum allowable price for payers (such as Medicaid and Medicare) based on other countries’ prices. When price ceilings are set below the market price, shortages occur — for proof, just look at the very countries that we would be relying on to set prices. Medicaid already enjoys the lowest available domestic price under the best price rule. Under the best price rule, drug manufacturers must provide Medicaid with the lowest price offered in the drug market. In some cases, Medicaid drug costs can be reduced by 50% or even 100%. If artificially low drug prices from other countries were applied to Medicaid, it would further distort the market and make it unsustainable for drug manufacturers to participate. This would force manufacturers out, leaving Medicaid patients with fewer drugs and treatment options. The MFN policy would also trigger even greater discounts to an already broken program through 340B, a program that large hospital systems use to enrich themselves. The 340B program was created in 1992 to give nonprofit hospitals and safety net hospitals the ability to buy outpatient drugs at a steep discount. In theory, the savings are supposed to be passed along to low-income and uninsured patients, but there’s no federal law requiring hospitals to use revenues on low-income patients or to disclose how much money they make from the sale of the discounted drugs. In 2022, hospitals reported an estimated $44.1 billion in revenue from 340B, while only spending $18.5 billion on charity care for low-income and uninsured patients. Of all the policies that stand to fix drug prices in the U.S., such as regulatory reforms, price transparency, or requiring 340B profits to be spent on its intended population, price controls remain an ineffective policy.

U.S. Rep. Nicole Malliotakis, Congressman Nick LaLota , Rep. Andrew Garbarino, Rep. Claudia Tenney. Senator Chuck Schumer, Congressman Hakeem Jeffries

08/12/2025

New Yorkers are speaking up and our elected representatives need to hear their words. Medicaid is the foundation of health for many New York families. Medicaid needs to be protected, and to do that we need to wisely examine the program to eliminate fraud, waste, and abuse so that New Yorkers who need it, and are entitled to it, continue to receive it.

Thank you Justin Schwartz for pointing out that we need to ensure the future viability of Medicaid which millions of New Yorkers rely upon for medical and fiscal security. U.S. Rep. Nicole Malliotakis, Congressman Nick LaLota , Rep. Andrew Garbarino, Rep. Mike Lawler.

By striking the right balance, we can protect both taxpayer dollars and the health of our communities.

08/11/2025

Studies continue to find insurer and PBM policies are preventing patient access to care Senator Chuck Schumer, Congressman Hakeem Jeffries, U.S. Rep. Nicole Malliotakis, Rep. Claudia Tenney it is time to adopt a bipartisan approach to solving this real world impediment to access to care. Your constituents don't consider this a partisan issue, they consider it a human issue. Please make this the year that the system serves the patients.

Formulary controls such as prior authorizations and step therapy are increasingly used by commercial payers, often delaying treatment and increasing prescription abandonment among patients. These restrictions disproportionately affect lower-income and medically complex patients, raising concerns....