RevCycle Intelligence November 2, 2023
CMS also finalized an offset to non-drug items and services to achieve budget neutrality with the lump-sum payments.
Hospital Outpatient Prospective Payment System (OPPS) providers participating in the 340B drug pricing program will receive a one-time lump-sum payment to offset losses between calendar years (CYs) 2018 and 2022, according to a final rule provision from CMS.
Before 2018, the Medicare payment rate for 340B drugs provided to outpatient hospitals was the average sales price (ASP) plus 6 percent. The CY 2018 OPPS/ASC final rule changed the payment rate to ASP minus 22.5 percent to reflect the costs incurred by 340B hospitals when acquiring 340B drugs. This rate was effective for drugs purchased from CY 2018 through the third quarter of...
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