CMS Finalizes Rule Reducing Medicare Part B Payments to 340B hospitals
The Centers for Medicare and Medicaid Services (CMS) finalized a rule on November 1, 2017 that would reduce the current Medicare Part B drug payment to 340B hospitals from average sales price (ASP) plus 6% to ASP minus 22.5%. However, rural sole community hospitals (SCHs), children’s hospitals, and PPS-exempt cancer hospitals are excluded from this payment adjustment in 2018.
ONS submitted comments to CMS in September 2017 on an earlier proposed rule, expressing concern for the severity of these cuts and urging CMS to consider the harm these cuts would have on access to oncology care services. CMS issued their ruling in response to concerns that hospitals receiving discounts on Medicare Part B medications were not able to track that any savings were being passed along to low-income, underserved, or underrepresented patients as the program initially intended.
Although ONS agreed that reform was needed to ensure the 340B program was helping those in need, ONS encouraged CMS to first study and provide proof that the cuts would not negatively impact oncology services. This includes access to patient education, treatment options, and symptom management efforts. ONS is preparing further comments for CMS in opposition of the new drug payment methodology and will continue to urge further study and research.