Responding to a federal court that ruled that the federal government has shortchanged hospitals in its payments for 340B-covered prescription drugs, the Centers for Medicare & Medicaid Services has revealed how it will compensate hospitals for its underpayments – at least for the 2023 fiscal year.
According to a CMS web site, the agency
…will apply the default rate (generally ASP plus 6%) to 340B-acquired drugs for the rest of the year. CMS also will reprocess claims our contractors paid on or after September 28, 2022, using the default rate (generally ASP plus 6%).
The CMS action comes after a federal court ruled that CMS cannot apply the average sales price (ASP) minus 22.5 percent drug payment rate for these drugs for the rest of the year. As a result, CMS will revert to paying the default rate (generally ASP plus six percent) under Medicare statute for 340B-acquired drugs.”
Virtually all community safety-net hospitals are eligible for 340B payments, which are a vital tool in helping such hospitals with the cost of caring for their uninsured and underinsured patients.
Learn more on the CMS 340B action from this CMS web site explanation.