340B Payment Reductions in the CY2018 Final OPPS Rule
A federal district court judge yesterday ruled that the Department of Health and Human Services would get "first crack at crafting appropriate remedial measures" to the nearly 30 percent cuts to Medicare payments affecting certain hospitals that participate in the 340B Drug Pricing Program.
In a highly unusual filing, Defendants seek to defend the 2019 OPPS Rule with arguments that Defendants forthrightly acknowledge the Court has already rejected. See Gov鈥檛 Mem. in Supp. of Mot to Dismiss New Claim & Opp鈥檔 to Mot. for Perm. Inj. With Respect to 2019 OPPS Rule (鈥淕ov鈥檛 Mot.鈥), ECF鈥
The Court concluded that the defendants 鈥 the U.S. Department of Health and Human Services and its Secretary (referred to collectively throughout as 鈥渢he Agency鈥) 鈥 acted in an ultra vires fashion by reducing the payment rate for drugs purchased through the 340B Program in the 2018 Outpatient鈥
In November 2018, Defendants issued a regulation requiring that, for calendar year 2019, the Centers for Medicare & Medicaid Services (CMS) reimburse drugs purchased under section 340B of the Public Health Services Act ("340B drugs") by using a methodology based on Average Sales Price minus 22.鈥
The Court determined that the U.S. Department of Health and Human Services ("Agency") acted in an ultra vires fashion when it reduced the payment, in the 2018 Medicare Outpatient Prospective Payment System Rule ("OPPS Rule"), 82 Fed. Reg. at 52, 362, for drugs purchased through the 340B Program.鈥
This Court should reject Defendants鈥 attempt to re-litigate the merits of the case or, alternatively, to decide on their own if the 340B hospitals are entitled to relief and if so what that relief might be. Defendants鈥 proposal is nothing more than an attempt to further delay resolution of this鈥