Maureen Testoni, the stalwart president and CEO of the renowned 340B Health Program, will join the long-running Monitor Mondays to discuss Eli Lilly’s escalating demands for hospitals to submit in-house claims data as a condition of receiving 340B drug discounts. Who will blink first? Register now to reserve your participation. Broadcast segments will also include these instantly recognizable features: · Monday Rounds: Ronald Hirsch, MD, vice president of R1 RCM, will be making his Monday Rounds. · The RAC Report: Healthcare attorney Knicole Emanuel, partner at the law firm of Nelson Mullins, will report the latest news about auditors. · Risky Business: Healthcare attorney David Glaser, shareholder in the law offices of Fredrikson &amp; Byron, will join the broadcast with his trademark segment. · Legislative Update: Folana Houston, legislative affairs analyst for Zelis, will report on current healthcare legislation.

Who will Blink First? 340B Health at Center Stage as Controversy Continues

Monitor Mondays

# Full Transcript

**Podcast:** Monitor Mondays

## Transcript

This program is brought to you by Panacea, MedLearn Media, and First Healthcare Compliance. One organization providing education, compliance, auditing, and support services for healthcare organizations nationwide. From the studios of RAC Monitor, this is Monitor Monday for June 15, 2026. Here's today's rundown.

Beleaguered 340B Health is coming to a showdown with a major drug manufacturer. Who will be the first to blink? Providing today's lead story is the president and CEO for 340B Health, Maureen Testoni. We will also hear from healthcare attorneys David Glaser and Nicole Emanuel. Adam Brenman has our Monday legislative update, and Dr. Ronald Hirsch makes his Monday rounds. Now here's the publisher of RAC Monitor and the host of Monitor Monday, Chuck Buck.

As we come on the air this morning, we're monitoring actions of the White House, even though President Trump has left Washington to attend the G-Summit meeting taking place in France. It's been reported that the Trump administration is floating a proposal to establish a permanent framework for the Medicare drug pricing negotiations as enabled by the Inflation Reduction Act. We'll have more on this developing story when the president and CEO for 340B Health, Maureen Testoni, joins us later in the broadcast.

We have a great deal of healthcare news report, and so we begin this morning with our good friend, Ronald Hirsch. Monday Rounds is sponsored by R1 Position Advisory Solutions. Here now making his Monday rounds is Dr. Ronald Hirsch. Well, good morning all. Today I have three OIG reports to discuss, but first an update on the WISER program. Once again, it appears Congress is not happy with CMS's program to pay AI companies to use their tools

to review prior authorizations for a select list of services and have added an amendment to the budget bill that would cease all funding for the program. To quote a letter from members of Congress to the House Appropriations Committee, it is also troubling that WISER contractors, those actually doing the prior authorization, are compensated by a percentage of the dollar value of the services they deny.

This payment mechanism clearly creates a perverse incentive to deny care, putting traditional Medicare beneficiaries at greater risk of not receiving needed care. Prior authorization has long been abused. It is bad for patients and providers. Now we'll have to wait and see if that goes anywhere. Now to the OIG reports. Last week they released two reports looking at prior authorization denials by Medicare Advantage plans

for care at skilled nursing facilities, inpatient rehab, and long-term acute care hospitals. And as I'm sure many of you could guess, MA plans denied a lot. Looking at SNFs, just in June of 2024, 12% of all requests were denied. And even more shocking is that if the denial was appealed, 95% of the time it was overturned.

That includes a 99.7% overturn rate for UnitedHealt...

Who will Blink First? 340B Health at Center Stage as Controversy Continues

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Who will Blink First? 340B Health at Center Stage as Controversy Continues

Transcript

Built for investment professionals

Every day you wait, your competitors are findingedge in conversations you're not hearing.

Every day you wait, your competitors are finding
edge in conversations you're not hearing.