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Association Comments on CY 2024 OPPS Proposed Rule

In a Sept. 11 letter to the Centers for Medicare & Medicaid Services (CMS), America’s Essential Hospitals commented on the calendar year (CY) 2024 Outpatient Prospective Payment System (OPPS) proposed rule.

The OPPS rule addressed Part B payment to hospitals in the 340B Drug Pricing Program, revised site-neutral payment policies, updated price transparency requirements, and made changes to outpatient quality reporting, among other provisions.

The association urged CMS to define the select group of hospitals with a safety net mission that provide a substantial share of uncompensated care and identify new policies that will ensure stable funding to these hospitals. America’s Essential Hospitals also called on CMS to provide an adequate annual payment update to cover the effects of inflation and rising workforce costs on hospitals. CMS proposed to pay 340B hospitals the full statutory default payment rate of 106 percent of average sales price (ASP) for a second consecutive year — a proposal the association supported in its comments.

America’s Essential Hospitals also urged the agency to:

  • Preserve patient access and minimize adverse effects of site-neutral policies by ensuring an adequate payment rate for essential hospitals.
  • Allow off-campus provider-based departments to retain their excepted status if they relocate or change ownership.
  • Adopt a flexible stance on data reporting, reconsider publicizing enforcement actions, and implement a safe harbor policy for accuracy in response to its new price transparency proposals.
  • Continue to refine the Outpatient Quality Reporting (OQR) Program to include measures that provide valid, accurate, and meaningful information to consumers about care quality.
  • Consider essential hospital operational challenges before introducing workforce safety measures in the OQR program.

Additionally, America’s Essential Hospitals responded to a request for information that sought comment on whether CMS should provide separate cost-based reimbursement through the Inpatient Prospective Payment System and the OPPS to cover the costs of maintaining a buffer stock of essential medicines. The association urged CMS to finalize the policy but to consider covering the costs of upfront drug purchases and investments in storage infrastructure. Furthermore, the association recommended that CMS implement a new policy in a way that would not exacerbate existing drug shortages.

Contact Senior Director of Policy Erin O’Malley at eomalley@essentialhospitals.org or 202.585.0127 with questions.

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About the Author

Shahid Zaman is a senior policy analyst at America's Essential Hospitals.

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