Statement on the CY 2023 Outpatient Payment Proposed Rule

By Soumi Saha, Senior Vice President of Government Affairs, Premier

Payment Update

As we found with the inpatient proposed rule, the 2.7 percent proposed outpatient payment update falls woefully short of reflecting the rising labor costs that hospitals have experienced since the onset of the pandemic. Coupled with record high inflation, this inadequate payment bump will only exacerbate the intense expense pressure on American hospitals. We urge CMS to finalize an update that takes into account these increased expenses.

340B Discount Drug Program Payment Cuts

Premier is pleased that CMS has committed to return to the ASP + 6% payment for 340B drugs for CY 2023, rather than continuing to implement cuts that the Supreme Court ruled were unlawful. Arriving at a remedy to address past reimbursement shortfalls based upon the outcome of the Court’s decision is essential to support hospital and patient access to high-quality pharmaceuticals.

Payment Adjustments for Additional Costs of Domestic NIOSH-Approved Surgical N95 Respirators

Premier is pleased to see CMS move towards finalizing its proposed payment adjustment to inpatient and outpatient Medicare payments to compensate hospitals for the increased cost of domestically produced N95s. We’re encouraged that the policy aligns with Premier’s recommendations to be mindful of provider burden. We encourage CMS to work with Congress to implement the OPPS adjustment in a non-budget neutral manner which will permit CMS to broaden this policy to other domestically manufactured critical medical supplies and drugs.

Payment Approaches to Appropriately Account for the Use of Algorithm-driven Services

Premier applauds CMS’ focus on payment approaches to appropriately account for the use of algorithm-driven services that assist providers in making clinical assessments, including clinical decision support software. When integrated directly into the electronic health record workflow, these algorithms and tools allow clinicians to provide evidence-based care that improves safety and outcomes at the point of care. We look forward to working with CMS to develop approaches to encourage their use in a way that helps close gaps in care.