CMS sets court-ordered 340B drug payments, but leaves back payment issues unresolved

The American Hospital Association and 340B Health applauded CMS' final ruling for its 2023 Medicare outpatient prospective payment system (OPPS) that will restore payments for drugs to 340B hospitals to the same amounts all other hospitals receive, but were disappointed that past repayment issues have still not been resolved.  

From 2018 to 2022, many 340B hospitals were paid nearly 30 percent less for drugs administered to Medicare patients, according to 340B Health. The Supreme Court ruled in June that those cuts were unlawful.   

The AHA said in a Nov. 1 statement that, while it appreciates CMS ending the unlawful cuts, the agency also needs to "promptly reimburse those hospitals that were harmed by their unlawful cuts in previous years."   

"In addition, we continue to call on the agency to ensure the remainder of the hospital field is not penalized for the prior unlawful policy, especially as hospitals and health systems continue to face immense financial pressures and workforce shortages," AHA said in the statement. "We do not believe the agency needs more time to put forth a separate rule on a remedy as it has had more than adequate time to correct its mistakes."

Maureen Testoni, 340B Health president and CEO, said in a Nov. 1 statement that she is pleased to see CMS has restored equity to the OPPS. 

"For 30 years, 340B has supported hospitals in serving patients living with low incomes, and full Medicare payments for those services are essential for the health care safety net," Ms. Testoni said. "We look forward to working with CMS on compensation for the hospitals that were financially harmed by the unlawful OPPS payment cuts in 2018 to 2022."

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