After Big Win in Court, CMS Proposes Cutting 340B Drug Payments Even More
Fresh off a major federal appeals court win, the U.S. Centers for Medicare & Medicaid Services (CMS) proposed this morning to cut Medicare Part B payments to hospitals for 340B-purchased drugs next year and in subsequent years by 6.2 percent below the current rate. CMS announced the cut in its hospital Outpatient Prospective Payment System (OPPS) proposed rule for calendar year 2021. Comments are due no later than 5:00 p.m. Eastern on Oct. 5.
Reimbursement for 340B drugs for disproportionate share hospitals (DSH), rural referral centers (RRC), and non-rural sole community hospitals (SCH) under OPPS would be set at average sales price (ASP) minus 34.7 percent, plus an add-on of 6 percent of ASP, for a net payment rate of ASP minus 28.7 percent. CMS has been paying these hospitals ASP minus 22.5 percent since 2018. Critical access hospitals, rural SCHs, and freestanding children’s and cancer hospitals have been exempted from the reductions and continue to be paid the default ASP plus 6 percent rate.
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