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44 Best Of Cms 340b Proposed Rule

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2017 07 13 centers for medicare & medicaid services the 340b drug pricing program allows certain hospitals and other healthcare providers to purchase s and biologicals the proposed rule cms 1678 p cms finalizes reimbursement cuts for 340b hospitals in a blow to 340b hospitals cms released a final rule significantly reducing medicare reimbursement for certain s purchased under the 340b program cms fact sheet on the opps proposed rule in the cy 2009 and cy 2010 opps asc proposed rule and final rule with ment period cms clarified that direct physician supervision is generally required for hospital outpatient therapeutic services that are furnished in hospitals critical access hospitals cahs and in provider based departments of hospitals cms proposes big 340b payment cuts outpatient rate cms on thursday released the 2018 hospital outpatient prospective payment system hopps proposed rule which includes a major cut to hospital 340b payments and a decrease in payment for certain services at newer off campus hospital outpatient departments 2018 opps proposed rule 340b program changes would cms believes these types of services are good candidates for packaging “the description of cms’ proposal in the rule is a little confusing since cms talks about the administration packaging at the apc level ” says shah cms finalizes medicare part b reimbursement cut for 340b still the change will have major repercussions in the 340b world when the proposed rule was first announced i posted answers to a myriad of questions about the proposal and its potential impact on 340b covered entities with the “rule” now in final form i can revisit some of those questions and answers 2018 opps final rule cms to cut 340b program 2018 opps final rule cms to cut 340b program payments in the proposed rule cms suggested a modifier to be used on s not purchased under 340b update cms finalizes 340b program reimbursement cut most significantly in the proposed rule providers would have been required to use an opps claims modifier to identify when s were not purchased under the 340b program in the final rule however cms reversed course and is now requiring that covered entities include a claims modifier “jg” or biological acquired with 340b drug pricing program discount for s that are acquired under the 340b program proposed rule would slash medicare payment for 340b drugs the rate does not vary based on participation in the 340b program the proposed rule would require hospitals to identify through a new modifier when a was not purchased under the 340b program in the absence of the modifier cms would presume that separately payable s had been acquired under 340b and pay asp minus 22 new medicare proposals that reduce payment to hospitals july 13 2017 cms released several proposed rules impacting health care including the 2018 outpatient prospective payment system opps proposed rule


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