Renacci leads bipartisan battle to stay Medicare reimbursement rate for safety-net hospitals

U.S. Rep. Jim Renacci is leading his home state Republican colleagues U.S. Reps. Dave Joyce and Mike Turner from Ohio, along with 18 other members of the U.S. House of Representatives, in a bipartisan quest to put on hold a new rule that makes a Medicare reimbursement cut of almost 30 percent for certain Medicare Part B prescription drugs.

The Ohio lawmakers, along with Republican Reps. Evan Jenkins of West Virginia, Dan Donovan of New York, Mike Bishop of Michigan, and other House members sent a letter on Dec. 20 asking House leaders to act before year’s end to delay a final rule from the Centers for Medicare and Medicaid Services (CMS) on the 2018 Medicare Hospital Outpatient Prospective Payment System (OPPS).

Specifically, the CMS rule finalized a Medicare reimbursement cut of 28.5 percent to hospitals that purchase and administer prescription drugs under the 340B Drug Pricing Program, changing the Medicare reimbursement rate from average sales price plus 6 percent to average sales price less 22.5 percent starting on Jan. 1, 2018.

The lawmakers noted that the Medicare Payment Advisory Commission, or MedPAC, an independent agency that advises Congress on issues affecting the Medicare program, has estimated that this is the minimum 340B discount received by hospitals. This cut of nearly 30 percent of the current reimbursement, they added, “amounts to as much as 25 to 40 percent of the 340B program savings hospitals receive.”

“While we acknowledge the concern over the growth in spending in this program and the need for greater oversight and transparency of such spending, we believe that this rule will be disproportionately devastating to our safety-net hospitals that care for the most vulnerable populations,” the lawmakers wrote in their letter to House Speaker Paul Ryan (R-WI) and Minority Leader Nancy Pelosi (D-CA).

The lawmakers would like to see a moratorium placed on the cuts “until Congress has an opportunity to strengthen the program through targeted clarifications and improvements,” they wrote.

The House members also pointed out in their letter that this is an issue Congress has expressed concern about before.

In July, when the 340B cut proposal was released by CMS as part of its proposed changes to the OPPS, 228 House members urged CMS to abandon it.

“Unfortunately, CMS ultimately finalized its proposal to reduce reimbursement to 340B providers and determined that it would distribute savings to all hospitals paid under the OPPS,” Renacci and the House members wrote.

More recently, Congress has begun reviewing the 340B program through the House Energy and Commerce Committee, the lawmakers wrote. “We have identified several areas that may need legislative resolution,” they added.

U.S. Rep. Marcy Kaptur (D-OH) joined her Republican counterparts from Ohio in signing the letter spearheaded by Renacci.