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  • Writer's pictureLyssa Limbrecht

CMS upholds 340B rate cuts under OPPS.

At the beginning of the month, the Centers for Medicare and Medicaid Services (CMS) finalized their payment rates for 2022. Unfortunately those rates are set to continue the damaging reimbursement cuts to many of our 340B covered entities.

Starting in 2018 these cuts have been a huge burden on 340B participating providers that fall under this OPPS ruling, which states that drugs and biologicals acquired under the 340B program will only be reimbursed at ASP minus 22.5%. With only 3 types of covered entities that are exempt from these rate cuts (Rural SCH, PPS-exempt cancer hospitals and children's hospitals), this has been a widespread issue, even before drug manufacturers started waging a war of their own against 340B.

With the continuing 22.5% rate cut, 340B facilities are at almost 30% below standard rates on 340B dispensations. Maureen Testoni, 340B Health President and CEO states:

“Four years’ worth of Medicare cuts have taken their toll on 340B hospitals, some of which have been forced to cut crucial services or postpone expanding care that would have benefited their communities. We remain concerned that more of these cutbacks will become necessary as the reductions persist.”

While we still wait for word on a U.S. Supreme Court ruling to determine if CMS does have the authority to enact a these payment reductions, we are going to maintain a hopeful stance against these cuts, and do everything we can to support our clients through all aspects of their 340B programs.

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