CMS has released a proposal to cut Part B reimbursement to 340B entities. In the notice of proposed rule making of Hospital Outpatient Prospective Payment System (OPPS), CMS is proposing cutting Part B reimbursement to 340B covered entities. The proposed payment reduction to hospitals is average sales price (ASP) less 22.5% for drugs purchased through the 340B program. Hospitals are currently reimbursed at ASP plus 6 percent. That's a 28.5% cut to reimbursement to the already vulnerable safety net hospitals. 340B Health, which represents 340B hospitals and health systems, released a statement strongly urging the Trump Administration to leave this out of the final rule, due later this year.
“The Medicare Payment Advisory Commission previously floated the idea of cutting payments to 340B hospitals but acknowledged that doing so would reduce the 340B benefit for these hospitals. MedPAC noted, “If 340B hospitals lose all or a significant share of the revenue from Part B drugs that they receive through the 340B program, they may decide to reduce their participation in the program.” A past survey of 340B Health members indicated that roughly 60 percent of hospitals would be likely or very likely to withdraw from 340B as a result of a payment cut that would take away all of their 340B savings on Part B drugs, which appears close to what CMS proposed today. An elimination of the 340B benefit from Part B drugs would lead to cuts in patient services.”
If you would like to know how this will impact your hospital or clinic, please contact us and would would be happy to help you perform an analysis showing the impact of this proposed rule. Hospitals, clinics, and providers have until September 11, 2017 to present comments to CMS on proposed changes to the Medicare reimbursement proposal.