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.

Related News Articles

Perspective
Public
More than 34.1 million Americans were enrolled in a Medicare Advantage plan in 2025, accounting for 54% of all Medicare beneficiaries. We have seen enrollment…
Headline
The Department of Health and Human Services Feb. 5 in a court filing said it would scrap its current 340B Rebate Model Pilot Program and potentially restart…
Headline
The Coalition to Strengthen America’s Healthcare Feb. 5 released a new research brief examining the impact of proposed site-neutral payment policies on…
Headline
A new AHA blog published Feb. 3 discusses how the 340B Drug Pricing Program serves as an effective solution to some of the nation’s most persistent and…
Blog
Public
Many Americans may be unaware that the services they rely on every day through their local hospital are supported by a program called the 340B Drug Pricing…
Headline
A KFF analysis released Jan. 28 found that Medicare Advantage insurers made nearly 53 million prior authorization determinations in 2024, an increase…