The final rule with comment period updates and revises policies under the Medicare Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System.
Hospital advocates aren’t taking the news lightly since Medicare Part B reimbursement cuts to hospitals for drugs purchased through the 340B program will now continue for a third year and site neutral cuts for clinic visits will continue in 2020 although two federal judges have ruled CMS overstepped its authority in making both payment reductions.
America’s Essential Hospitals reacted to the rule published Nov. 1,
By plowing ahead with damaging cuts to hospitals in the 340B Drug Pricing Program and ignoring clear congressional intent by expanding cuts to grandfathered provider-based outpatient clinics, CMS undermines the foundation of care for the nation’s most vulnerable people. The agency also prolongs confusion and uncertainty for hospitals by maintaining unlawful policies it has been told to abandon in clear judicial directives.
The 340B program, which allows participating hospitals and other providers to purchase certain covered outpatient drugs at discounted prices from manufacturers and use the savings they receive to provide services to low-income and uninsured patients. The CMS final rule means the agency will continue its 22.5% payment rate cuts for some drugs under the 340B program.
Despite a federal court ruling that the agency acted outside of its authority when it made the cuts, CMS also finalized site-neutral payments for hospital outpatient departments predicting savings of $800 million by 2020 and noting the government still has appeal rights on the federal case.
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