FAH Hospital Policy Blog

Perspectives on health policy affecting America's hospitals and the patients we serve.

Medicaid | Quality & Safety | Transparency | FAH Policy Blog Team

FAH Comments on CY 2022 Medicare OPPS Proposed Rule

In comments submitted today, FAH reiterated its full support for CMS’s prospective budget-neutral 340B payment policy to continue to pay Average Sales Price (ASP) minus 22.5 percent for 340B-acquired drugs. “We agree with CMS that this policy ‘better, and more appropriately, reflects the resources and acquisition costs that [340B] hospitals incur’ while also ensuring that  Medicare beneficiaries ‘share in the savings on drugs acquired through the 340B Program,’” the FAH comment letter notes. The letter also highlights findings from a study issued by Avalere Health that reversing the policy in 2021 would not only increase beneficiaries’ drug copayments by an estimated 37% on average, or $472.8 million, at 340B hospitals, but would reduce net payments to 82% of all hospitals paid under the OPPS – including 89% of rural hospitals, 77% of rural 340B hospitals, 100 percent of rural sole community hospitals, and even 49% of all 340B hospitals.

Among other issues addressed in the letter, FAH applauded CMS’s proposal to halt and reverse its 2021 decision to eliminate the hospital inpatient only (IPO) list and to restore to the list 298 services that had been removed. Instead, the FAH strongly supported the case-by-case evaluation of procedures against CMS’s longstanding clinical criteria for removal. 

In addition, while FAH noted its support for price transparency initiatives that provide access to clear, accurate, and actionable information, it strongly opposed the proposed changes to the civil monetary penalty amounts as premature and inappropriate, especially in the midst of the ongoing public health emergency. “Additional time and experience both during and after the COVID PHE are needed to determine whether current CMS educational and enforcement authorities are sufficient, including, for example, the need to identify factors that will be considered in imposing a civil monetary penalty in any individual case,” according to the letter. 

Read the full letter here.