The Centers for Medicare & Medicaid Services should withdraw its proposal to reduce Medicare Part B payment for drugs acquired through the 340B Drug Pricing Program, AHA today told the agency in comments on its outpatient prospective payment system proposed rule for calendar year 2018. “CMS lacks statutory authority to impose such a drastic reduction in the payment rate for 340B drugs, effectively eviscerating the benefits of the program,” wrote AHA Executive Vice President Tom Nickels. CMS proposed to pay for separately payable, non pass-through drugs acquired through the 340B program at the average sales price minus 22.5%, rather than ASP plus 6%. “Rather than punitively targeting 340B safety-net hospitals serving vulnerable patients, including those in rural areas, we urge CMS to redirect its efforts to halt the unchecked, unsustainable increases in the price of drugs,” Nickels said. Among other comments, AHA opposed the removal of total knee replacement, as well as partial hip arthroplasty and total hip arthroplasty procedures from the inpatient-only list; supported CMS’s proposal to reinstate the moratorium on enforcement of some direct supervision requirements for outpatient therapeutic services provided in critical access hospitals and small and rural hospitals, but urged the agency to make the enforcement moratorium permanent and continuous; and supported CMS’s proposal, with certain revisions, to update its laboratory date-of-service billing policies.

Perspective
Public
Approximately 35 million Americans are enrolled in Medicare Advantage plans in 2026, and that number is expected to grow to about 45 million MA enrollees by…
Headline
The Centers for Medicare & Medicaid Services has released details on downloading its upcoming fiscal year 2025 Program for Evaluating Payment Patterns…
Headline
The AHA today urged Eli Lilly to abandon its 340B Drug Pricing Program claims-data policy and work with the AHA to develop a functional third-party…
Headline
The Department of Health and Human Services Administration for Community Living has launched the first phase of its Health at Home Challenge, a competition to…
Headline
The AHA shared the following statement with the media in response to a report released May 7 by Families USA.   “This report is long on rhetoric and…
Headline
The AHA May 7 wrote to House and Senate lawmakers in support of the Medicare Advantage Improvement Act (H.R. 8375/S. 4384), bipartisan and bicameral…