CMS Finalizes 2027 Rule Cutting 340B Rates, Expanding Site-Neutral Pay
CMS finalized its 2027 hospital outpatient and ASC payment rule on Nov. 4, raising outpatient and ASC payment rates 2.3% for facilities meeting quality reporting requirements. The rule cuts payment for 340B-acquired drugs to average sales price minus 28%, expected to reduce Medicare drug spending by $4.35 billion and beneficiary costs by $1.1 billion in 2027, with nondrug outpatient payments raised to offset the cut under budget-neutrality requirements. CMS is also accelerating recoupment of prior 340B overpayments, expanding site-neutral payment to imaging services at off-campus provider-based departments, continuing the three-year phaseout of the inpatient-only list by removing 637 services, and adding prior authorization requirements for eight more botulinum toxin injection codes. The American Hospital Association criticized the rate update, 340B cuts, and site-neutral expansion as harmful to hospitals serving rural and underserved communities.