On Oct. 13, the Centers for Medicare & Medicaid Services (CMS) announced that it will restore payments for certain 340B outpatient drugs to average sales prices (ASP) plus 6% for the rest of calendar year (CY) 2022 and will reprocess claims paid on or after Sept. 28. This announcement followed the U.S. Supreme Court’s decision in June invalidating the CMS’ reduction of payments for 340B drugs to the ASP minus 22.5% starting in CY 2018 [refer to Washington Highlights, June 17]. On Sept. 28, the U.S. District Court for the District of Columbia vacated the 2022 Outpatient Prospective Payment System rule to the extent that it reduced Medicare Part B payments for 340B drugs, contrary to the Supreme Court’s holding.
The determination of remedies covering underpayments in 2018 through Sept. 27 awaits further court proceedings. The CMS will finalize the payment rate for CY 2023 when it publishes the CY 2023 Inpatient Prospective Payment System final rule, which should occur in the next few weeks.
- Washington Highlights