Confirmed CMS Reduced Reimbursement Rates DO NOT Affect Your Factor Program!

By November 1, 2019News

November 2019 — On November 1, CMS issued their final rule for the upcoming calendar Year (CY2020) which includes finalizing the proposal to continue paying an adjusted amount (ASP – 22.5%) for 340B drugs under the Medicare Outpatient Prospective Payments System (OPPS).

While this may appear frightening to your program at first glance, remember your 340B Outpatient Factor Program bills claims under a pharmacy billing number. The OPPS rule sets annual payment rates and reimbursement policies under Medicare for hospital outpatient departments only.

That’s good news because your claims made using a pharmacy billing number are not affected by this reduction!

We will alert you to any updates on this issue. If you have questions, please feel free to call Mary Ann Barth or Holly Frye at (949)223-9828.