The U.S. Centers for Medicare & Medicaid Services (CMS) could disclose as soon as today whether it will continue, end, or modify the nearly 30% cut in certain hospitals’ Medicare Part B reimbursement for 340B-purchased drugs.
The White House Office of Management and Budget (OMB) on Friday cleared CMS to publish its calendar year 2022 hospital Outpatient Patient Payment System (OPPS) final rule. CMS historically tries to post its OPPS final rule for public inspection at least 60 days before the rule takes effect. Today is 60 days before the Jan. 1, 2022, effective date.
The Trump administration began the payment cut in 2018 on the grounds that it saves Medicare and its beneficiaries money. Hospital groups point out that the cuts are actually budget neutral, so the policy only enriches non-340B hospitals and has no impact on patient costs. The cut affects 340B disproportionate share hospitals, rural referral centers, and non-rural sole community hospitals. Their annual revenue loss is pegged at $1.6 billion. CMS proposed keeping the cut in place next year when it published its CY 2022 OPPS proposed rule in August. Hospital groups have pleaded with the Biden administration to end the cut.
The U.S. Supreme Court has scheduled arguments for Nov. 30 on whether lower federal courts should defer to CMS’s position that federal law lets it set a lower drug reimbursement rate for 340B hospitals than for others. It is also reviewing whether hospital groups had the right to sue in the first place.