HRSA Issues Long-Awaited Proposed Rule on Administrative Dispute Resolution Process
The Health Resources and Services Administration has issued a long-awaited proposed rule updating the 340B administrative dispute resolution (ADR) process.
Medicare Outpatient Expenditures Estimated to Grow $6.5B
The calendar year 2023 Outpatient Prospective Payment System (OPPS) final rule, issued Nov. 1, 2022, by the Centers for Medicare and Medicaid Services estimates that Medicare expenditures under OPPS will increase by $6.5 billion, relative to estimated current year payments, based on changes in the final rule. Key provisions are:
Court Rules HHS Must Restore Full 340B Payments to Hospitals for Rest of 2022
On Sept. 28, a federal district court ruled that the Department of Health & Human Services (HHS) must immediately halt the department’s cuts to outpatient reimbursement rates for the remainder of 2022 for certain hospitals that participate in the 340B Drug Pricing Program. HHS will begin restoring a payment rate of average sales price plus […]
CHA Comments on OPPS Proposed Rule
CHA submitted comments on the calendar year (CY) 2023 outpatient prospective payment system (OPPS) proposed rule. In the letter, CHA raises concerns about the inadequate proposed market basket update and asks CMS to use alternative sources of data that better reflect input price inflation experienced by providers to calculate the CY 2023 market basket update. […]
CHA Issues Summary of CY 2023 OPPS Proposed Rule, Webinar on Aug. 22
CHA has issued a comprehensive summary of the calendar year (CY) 2023 outpatient prospective payment system (OPPS) proposed rule.
Supreme Court Rejects HHS Reduction of Prescription Drug Reimbursement for 340B Hospitals
On June 15, the U.S. Supreme Court ruled in favor of the American Hospital Association (AHA) in its lawsuit against the federal Department of Health & Human Services (HHS) challenging HHS’ reduction of prescription drug reimbursement rates for 340B hospitals for 2018 and 2019.
HRSA Announces 340B Eligibility Exceptions Due to COVID-19 Public Health Emergency
The Health Resources and Services Administration (HRSA) announced the implementation of Section 121 of the Consolidated Appropriations Act of 2022, which creates an eligibility exception that permits certain hospitals’ reinstatement into the 340B Drug Pricing Program if they meet certain qualifications.
CMS Issues CY 2022 OPPS Final Rule, Increases Price Transparency Penalties
On Nov. 2, the Centers for Medicare & Medicaid Services (CMS) finalized Medicare payment rates for hospital outpatient and ambulatory surgical center (ASC) services. CMS estimates that Medicare expenditures under the outpatient prospective payment system (OPPS) will increase by $1.3 billion based on changes in the final rule.
CHA Issues Summary of FFY 2022 Inpatient Prospective Payment System Final Rule
CHA has issued a detailed summary of the federal fiscal year (FFY) 2022 inpatient prospective payment system (IPPS) final rule. The policy and payment provisions in the final rule are effective for FFY 2022 discharges, beginning Oct. 1.
CHA Comments on CY 2022 OPPS Proposed Rule
CHA has submitted comments to the Centers for Medicare & Medicaid Services (CMS) on the calendar year 2022 outpatient prospective payment system (OPPS) proposed rule.