Today is the deadline for public comments on Medicare’s proposed rule for how it will pay for hospital outpatient services and clinician-administered drugs in 2023.
340B stakeholders will be paying close attention to comments on how Medicare Part B should make hospitals whole for five years of what 340B hospitals argue are illegal underpayments for 340B-purchased drugs. The Centers for Medicare & Medicaid Services (CMS) reduced Part B reimbursement for 340B drugs in 2018 from average sales price plus 6% to ASP minus 22.5%. The U.S. Supreme Court declared the reductions illegal in June but only ruled on the 2018 and 2019 fiscal years. Hospital groups and CMS are sparring in federal district court in Washington, D.C., over how 340B hospitals should be repaid and whether the repayments will span the entire five year period.
CMS said in its proposed rule that it expects to resume paying 340B hospitals at the ASP plus 6% rate in 2023 and make a corresponding decrease in non-drug payments to all hospitals in OPPS.
340B Report plans to report in a coming issue on key stakeholders’ comments. CMS is expected to release its OPPS final rule for 2023 in early November.
Hospital Recertification Deadline Coming Soon
Another 340B program-related deadline is around the corner. Monday, Sept. 19 is the last day for 340B hospitals to recertify their eligibility for 340B drug discounts.
340B covered entities must annually recertify their eligibility to remain in the 340B program and continue purchasing covered outpatient drugs at discounted 340B prices. Non-hospital entities went through the recertification process earlier this year.