CMS proposes deep 340B payment cuts in CY 2027 OPPS rule, legal challenge expected

CMS's proposed CY 2027 Hospital Outpatient Prospective Payment System rule includes significant payment reductions for drugs purchased under the 340B program. The agency seeks to further lower reimbursement for 340B-acquired drugs from average sales price plus 6% to ASP minus 22.5%, expanding cuts previously applied only to excepted hospitals. This follows ongoing litigation over prior 340B payment reductions. If finalized, the cuts would reduce revenue for many hospitals and affiliated outpatient clinics that rely on 340B savings to fund charity care. The proposal is likely to face legal challenge from hospital groups. The comment period will be critical for hospitals to oppose the cuts.