Federal Policy
CMS Proposes Expanded Site-Neutral Payment and 340B Changes for Hospitals
CMS has proposed expanding site-neutral reimbursement policies and modifying the 340B drug pricing program, affecting hospital payment rates. The American Hospital Association and other provider groups oppose the proposals, arguing they fail to account for Medicare patient volume, care complexity, and regulatory requirements hospitals face. The timing and effective date of the proposals are not specified in this summary. The changes would affect hospital finances and facility investment, with potential downstream impacts on Medicaid-participating safety-net hospitals that rely on 340B savings and serve dual-eligible beneficiaries.
Why it mattersMedicaid managed care plans and state agencies should monitor how these Medicare payment changes affect hospital participation and access for dual-eligible beneficiaries, particularly at safety-net facilities dependent on 340B revenue.