A federal appeals court recently ruled that 340B hospitals will now be subject to Medicare cuts in outpatient drug payments by nearly 30%, reversing an earlier ruling calling those cuts illegal.

The 340B Drug Pricing Program is a federally managed program that allows certain types of hospitals to receive special pricing on outpatient drugs from manufacturers. Its sole intent is to allow covered entities to stretch federal resources to provide more care to patients, specifically the uninsured and underinsured, including Medicare patients.

In August 2020, the 2020 Hospital Outpatient Payment System (OPPS) 340B rate reduction was upheld, and CMS published the 2021 OPPS Proposed Rule and the Ambulatory Surgical Center (ASC) Payment System Proposed Rule regarding 340B reimbursements rates.

As a participant in the ever-evolving healthcare landscape and to continually provide value to your clients, it is important to stay informed about which covered entities are participating in the 340B program and to understand how program changes impact your clients. This comprehension helps you prepare for discussions and improves your credibility with your clients.

 

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