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CMS Seeks Comments on Proposed Hospital Survey of 340B Outpatient Drug Costs

For CFOs, CMOs, pharmacy managers

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The Centers for Medicare & Medicaid Services (CMS) has proposed surveying hospitals about their acquisition costs for certain covered outpatient drugs under the 340B drug savings program.

In the outpatient prospective payment system final rule for calendar year 2018, CMS finalized a policy to adjust payment for separately payable outpatient drugs acquired by 340B-eligible hospitals from average sales price (ASP) plus 6% to ASP minus 22.5%.

In a lawsuit brought by the American Hospital Association (AHA), the Association of American Medical Colleges, and others, a federal judge last year ruled that the cut was unlawful, in part because the Department of Health and Human Services had not collected the necessary data to set payment rates based on acquisition costs.

CMS has appealed the ruling, stating in a notice, “In the event that the ruling is affirmed, CMS believes that it is important to begin obtaining acquisition costs for specified covered outpatient drugs to set payment rates based on cost for 340B-acquired drugs when they are furnished by certain covered entity hospitals.”

The notice was published in the Sept. 30 Federal Register, with comments due by Nov. 29.