BioCentury
ARTICLE | Politics & Policy

Avalere says hospitals will benefit overall under new 340B rule

January 29, 2018 5:05 AM UTC

The Avalere Health LLC unit of Inovalon Holdings Inc. (NASDAQ:INOV) estimates that 85% of hospitals will receive a net increase in overall Medicare Part B reimbursement in 2018 under a rule CMS implemented in January that reimburses for certain Medicare drugs at 340B prices. The firm said the increase will be generated by redistributed savings.

Under the new Medicare Outpatient Prospective Payment System (OPPS) rule, CMS will reimburse hospitals that receive infused Medicare Part B drugs through the 340B program at a rate of average sales price (ASP) minus 22.5% instead of the current rate of ASP plus 6%. The agency said it would reallocate the savings from the new rule "equally to all hospitals," which Avalere said will actually result in an overall net payment increase to hospitals (see BioCentury Extra, Nov. 1, 2017)...