FAH Hospital Policy Blog

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

Telehealth | 340B | Sarah Aillon

FAH Submits Comments on CY 2023 OPPS Proposed Rule

Today the FAH submitted comments on CMS’s proposed rule on the CY 2023 hospital outpatient prospective payment system (OPPS). The FAH’s letter reinforced support of the current 340B drug payment policy following the June 2022 Supreme Court ruling invalidating the policy. FAH comments also asserted that CMS should not, as a matter of policy, and may not, as a matter of law, directly or indirectly seek to recoup non-340B drug payments, which were properly made under the OPPS Final Rules in CYs 2018-2022. FAH comments also urge CMS to lower the 340B budget neutrality adjustment for CY 2023 from 4.04 percent to no higher than the original budget neutrality factor for the policy at 3.2 percent.

The FAH letter supported a number of other provisions in the OPPS proposed rule that would:

  • Implement the new Rural Emergency Hospital (REH) payment model.
  • Protect special payments to sole community hospitals and adopt a 5 percent floor on decreases in hospital wage index changes.
  • Allow mental health services to be furnished remotely by hospital staff to beneficiaries in their homes as covered outpatient services under the OPPS.
  • Permit coverage of mental health services via audio-only telehealth given an individual patient’s technological limitations, abilities, or preferences.
  • Delay the requirement of an in-person visit within six months prior to the initial mental health telehealth service for 151 days after the end of the PHE.
  • Allow direct supervision to be provided via a virtual presence through the end of 2023, rather than the end of the PHE – for cardiac, intensive cardiac, and pulmonary rehabilitation services provided via telehealth (which is permitted through 2023).
  • Change the calculation of Medicare reimbursement for organ acquisition costs for research cases.

To see all of FAH’s recommendations and a copy of the letter, click here.