BETHESDA, MD 30 November 2009—The federal government expects to pay hospitals $32.2 billion in 2010 for outpatient services covered under Medicare, a $1.9 billion increase over last year's spending, the Centers for Medicare and Medicaid Services (CMS) announced in late October.

Payments to be made in 2010 under the outpatient prospective payment system (OPPS) include a 2.1% inflationary increase for outpatient services at hospitals that report specific quality data to CMS and a 0.1% increase for hospitals that do not submit quality data.

Included in the OPPS final rule is what CMS called a "payment adjustment" to account for hospital pharmacy overhead costs for separately payable drugs and biological products that are not bundled into ambulatory payment classification (APC) groups.

The adjustment leaves the formula for the payment rate unchanged from 2009: manufacturer-reported average sales price (ASP) + 4%. CMS had previously proposed reducing the rate to ASP plus 3%.

ASHP and other pharmacy stakeholders had asked the agency to raise the reimbursement amount for separately paid drugs to at least ASP plus 6%, the amount paid to office-based physician practices.

"ASHP is disappointed that CMS will not reimburse separately payable drugs at ASP plus 6%, since ASP plus 4% is insufficient to support core pharmacy services, in particular the costs of ensuring safe medication use," said Justine Coffey, ASHP's director of federal regulatory affairs.