340b recent legislation.pptx - In OPPS final rule CMS...

In OPPS final rule, CMS boosts payment rates by 3
.8%; will pay ASP plus 6% for 340B drugs | AHA Ne
ws
Talia Brown, Bella
Ferguson, Ben Kujawa,
Bradley Hilton, &
Yonathan Hailé

340B from 1992-2022
•
Signed into law in 1992, mandates that manufacturers deliver outpatient medications at
“significantly discounted” costs to qualified entities.
•
Affected:
• Eligible hospitals • Pharmaceutical companies
• Patients • Government agencies
•
Intended to “allow covered entities to stretch scarce federal resources as far as possible,
reaching more eligible patients and providing more comprehensive services”
•
From 2000 and 2020, covered entities participating increased from 8,100 to 50,000.
•
By 2020, they are expected to be $38 billion.

Supreme
Court
Decision:
AHA v. Becerra
• CMS posted on November 1st 2022, that it will
increase Medicare hospital outpatient payment
rates by 3.8% in 2023.
•
The provisions of this ruling will take effect on
January 1, 2023.
•
This ruling updates the requirements for the
Hospital Outpatient Quality Reporting (OQR)
Program; the ASC Quality Reporting (ASCQR)
Program; and the Rural Emergency Hospital
Quality Reporting (REH) Program.

Supreme Court decision: AHA v.
Becerra
•
Unanimous Supreme Court decision in American Hospital Association
v. Becerra .
•
Federal Level
•
DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services 42
CFR Parts 405, 410, 411, 412, 413, 416, 419, 424, 485, and 489 [CMS-1772-FC; CMS-1744-F; CMS-
3419-F; CMS-5531-F; CMS-9912-F] RIN 0938-AU82
•
Department of Health and Human Services Ruling Document