The Centers for Medicare and Medicaid Services on Tuesday finalized its annual outpatient hospital payments rule with a lower-than-proposed rate bump and its major, industry-opposed policy shifts moderated, but largely intact.

The 2027 Hospital Outpatient Prospective Payment (OPPS) and Ambulatory Surgical Center (ASC) Payment Systems rule outlines a 2.3% reimbursement increase for those meeting applicable quality reporting requirements. That’s below the proposed 2.4% increase, and reflects a 3.2% projected hospital market basket increase and a 0.9 percentage point productivity adjustment.

The agency is also moving forward with a substantial and controversial cut in 340B drug reimbursements, though not quite to the extent that it initially proposed.

The final rule adjusts these drug payments down from the current bar of average sales price (ASP) plus 6% to ASP minus 28%, as opposed to the proposed 33.4% below ASP. To make the reimbursement change budget neutral as required by statute, OPPS payments for non-drug services will be boosted by 7.5%.

CMS said it tweaked the proposed 340B reimbursement cut based on 340B ceiling price data from the Health Resources and Services Administration, with the baseline reductions informed by a drug acquisition cost survey it conducted earlier this year. Those changes will reduce Original Medicare drug payments by $4.35 billion and the drug payments from beneficiaries by $1.1 billion (or $900 on average per beneficiary who receives an affected drug from a hospital outpatient department) in the policy’s first year, CMS said.

The rate adjustment did little to calm hospital industry groups who’d railed against the 340B reimbursement changes as a threat to safety-net care and a gift to for-profit hospitals that do not participate in the subsidy program but would benefit from the budget-neutral offset.

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