Pharmacy Group Speaks Out Against Medicare Reimbursement Plan

ASHP expresses concern over proposed cuts to Medicare payment rates for drugs that hospitals acquire under the 340B Drug Pricing Program.

Proposed cuts to the Medicare payment rates for drugs that hospitals acquire under the 340B Drug Pricing Program, if enacted, could have devastating consequences for the low-income and uninsured patients that receive care from the nation’s safety net hospitals, according to pharmacy group ASHP.

The new rule on outpatient payment rates for hospitals and ambulatory surgical centers, proposed by the Centers for Medicare & Medicaid Services, would reduce the reimbursement for drugs acquired through the federal 340B program from average sales price (ASP) plus 6 percent to ASP minus 22.5 percent.

“The CMS proposal to reduce reimbursement of 340B-purchased drugs has the potential to be very harmful to the sickest and most vulnerable patients by endangering their access to essential healthcare services,” said ASHP Chief Operating Office and Senior Vice President Kasey K. Thompson, Pharm.D., M.S., M.B.A. “These changes run counter to the statutory intent of the federal 340B program and will incur a steep cost to the people and the organizations that can least afford it.”

The 340B drug-discount program allows community safety net providers — organizations that serve low-income patients, including critical access, children’s, and cancer hospitals — to provide care for tens of millions of uninsured and underinsured people every year. The discounts allow 340B-eligible entities to provide free or low-cost medications, establish programs to increase medication adherence, and provide additional screening and preventive care services.

ASHP is currently gathering member feedback on how this reimbursement change will impact covered entities. ASHP will submit detailed comments outlining the impact of the proposal on ASHP members and their patients and organizations in advance of CMS’ September 11 deadline.