CMS Proposes Even Deeper 340B Cuts in 2021 Outpatient Rule
On August 4, the Centers for Medicare and Medicaid Services (CMS) released its 2021 Outpatient Prospective Payment System (OPPS) Rule
. Like previous rules, the agency proposes to continue reimbursement cuts to certain 340B hospitals. However, in response to its Spring 2020 Hospital Acquisition Cost Survey, it is proposing a net payment rate of Average Sale Price (ASP) minus 28.7%. CMS also seeks comment on whether it should continue its current payment policy first suggested in the 2018 OPPS rule of ASP minus 22.5%.
In addition to the 340B cuts, CMS proposes the following policy changes for 2021:
- A net increase in OPPS payments of 2.6% from 2020.
- Adding cervical fusion with disc removal and implanted spinal neurostimulators to the prior authorization list.
- Removing the inpatient-only list of procedures over the course of three years.
- Changing the level of supervision required for certain outpatient therapeutic services from direct, to general.
- Making changes to the Hospital Outpatient Quality Reporting and Star Ratings.
- Removing certain restrictions on the expansion of physician-owned hospitals that qualify as “high Medicaid facilities.”
WHA is continuing to review the proposed rule in advance of the October 5 comment deadline. Please contact WHA’s Director of Federal and State Relations, Jon Hoelter
, for more information.
This story originally appeared in the August 06, 2020 edition of WHA Newsletter