The CMS on Thursday issued a notice that it will collect information from hospitals participating in the 340B drug discount program about the prices they pay for eligible drugs.
Although a federal judge tossed the CMS' planned 340B reimbursement cuts in December, the agency hopes that it will win an appeal and move forward with the changes. If that happens, the CMS will need information on the actual prices that hospitals pay for drugs under the 340B program to calculate average sales prices and make the cuts.
"This will ensure that the Medicare program uses taxpayer dollars prudently while maintaining beneficiary access to these drugs and allowing beneficiary cost-sharing to be based on the amounts hospitals actually pay to acquire the drugs," the CMS said in the notice.
Hospitals that participate in 340B buy drugs at discounted rates and get reimbursed by HHS when they prescribe medications to Medicare beneficiaries. HHS uses the Outpatient Prospective Payment System rates to determine the reimbursement level.
Before 2018, the formula HHS used to determine 340B reimbursements was the average sales price plus 6%. But HHS tried to slash 340B payments in 2018 when it changed the OPPS formula to average sales price minus 22.5%, a nearly 30% cut.
Several hospital groups sued HHS over the cuts last year, saying the department overstepped its authority when it chopped 340B reimbursements.
A federal judge overturned the cuts because the HHS had based the new rates on agency estimates of 340B hospitals' drug acquisition costs instead of the drugs' average sales prices.
