340B Health, ASHP chide CMS' final payment rules

Organizations representing thousands of hospital pharmacies are criticizing CMS' plan to not provide further reimbursement to 340B hospitals after paying a $9 billion lump sum. 

On Nov. 2, CMS released its annual decisions for the 340B program-acquired drug payment and three other budget rules. CMS is planning to distribute the $9 billion to about 1,700 hospitals after courts ruled the agency illegally cut reimbursement rates between 2018 and 2022. 

The American Society of Health-System Pharmacists and 340B Health said Nov. 3 they support the lump sum decision but have qualms about other decisions. 

Here is what the two organizations said:

ASHP: "[We] remain deeply concerned that the unnecessary offset cuts to non-drug services reimbursement are punitive, functioning as a de facto means to claw back reimbursement due for 340B program cuts, and will harm already strained hospitals, potentially reducing access and services for patients."

340B Health: "We strongly disagree with CMS' decision to cut future reimbursement to hospitals, including 340B hospitals, to offset these lump-sum repayments. This approach diminishes the remedy's impact and, as applied to 340B hospitals, results in an estimated 16 years of underpayments for hospitals that provide 77% of Medicaid care and 67% of the nation's unpaid hospital care for the benefit of low-income and rural communities.

"The CMS rule also fails to address hospital concerns that Medicare private plans that followed CMS in imposing their own 340B cuts will not be required to repay hospitals for those reductions. For many hospitals, the majority of their Medicare patients are enrolled in these plans, representing millions in lost revenue over the period in which the unlawful cuts were in place. We urge the agency to reconsider this detrimental approach to correcting the situation."

Copyright © 2024 Becker's Healthcare. All Rights Reserved. Privacy Policy. Cookie Policy. Linking and Reprinting Policy.


Featured Whitepapers

Featured Webinars