CMS Part B Payment Cuts Plateau in 2021 Medicare Hospital OPPS Final Rule

Thoughtware Alert Published: Dec 17, 2020
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CMS has refrained from further cutting hospital Part B payments for 340B drugs. On December 7, 2020, CMS issued its Medicare hospital Outpatient Prospective Payment System (OPPS) final rule Part B payments at average sales price (ASP) minus 22.5 percent to be effective January 1, 2021. 

Although no additional cuts are planned for 2021, CMS has made efforts to obtain hospital actual acquisition cost data via surveys and had set a tone for further cuts in the future. Response to the administration’s initial drastic cut in 2018 (to ASP minus 22.5 percent) led to legal action. Hospital groups ultimately lost the case in federal court and may still appeal the decision. 

CMS encourages comments on the final rule electronically or via mail. For more information, reach out to your BKD Trusted Advisor™ or submit the Contact Us form below.

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