OIG Report on Medicare Payment for OPPS Drugs
The OIG has released a report on “Payment for Drugs under the Hospital Outpatient Prospective Payment System.” The OIG found that in the aggregate, Medicare payment amounts for separately-payable drugs furnished under the OPPS were substantially higher (31 percent ) than acquisition costs for 340B hospitals. The OIG characterizes this as “an expected result given the purpose of the 340B Program,” which is to allow entities that provide services to disproportionately low-income, uninsured, and underinsured populations to purchase drugs at reduced prices. The OIG also found that OPPS payments were similar to acquisition costs for non-340B hospitals. The findings were based on a comparison of first-quarter 2009 Medicare payment amounts to first-quarter 2009 hospital acquisition costs for 32 separately payable drugs from a sample of 99 340B hospitals and another sample of 110 non-340B hospitals. The report contains no recommendations to CMS.
