The Centers for Medicare & Medicaid Services (CMS) announced that it will pay 340B hospitals the full Outpatient Prospective Payment System (OPPS) payment rate for Part B drugs for the remainder of 2022, in compliance with a recent federal district court decision in favor of America’s Essential Hospitals.
In the Sept. 28 decision, the district court judge ruled CMS must vacate the portion of the 2022 OPPS final rule that implemented the Part B cuts to 340B hospitals. CMS’ announcement states that, for the remainder of 2022, CMS will pay 340B hospitals at the default OPPS payment rate of average sales price (ASP) plus 6 percent, instead the 77.5 percent of ASP rate at which CMS has paid 340B hospitals since 2018. CMS is updating its systems to apply the default rate for Part B drug claims going forward and says it will reprocess claims that were paid at the lower rate on or after Sept. 28 using the ASP plus 6 percent rate instead.
Contact Senior Director of Policy Erin O’Malley at firstname.lastname@example.org or 202.585.0127 with questions.