Hospital Survey for Specified Covered Outpatient Drugs (SCODs) (CMS-10709)

The 340B program sets a ceiling on the price that covered entities pay for outpatient drugs. On December 27, 2018, the U.S. District Court for the District of Columbia ruled that the HHS Secretary did not have statutory authority to change Medicare Payment rates for 340B Drugs. The Courts asserted in part that the Secretary had not collected the necessary data to set payment rates based on acquisition costs. As a result of this ruling, CMS believes that it is important to begin obtaining acquisition costs for specified covered outpatient drugs to set future payment rates based on cost for certain 340B Hospitals. This survey will be used to help determine payment amounts for each drug acquired through the 340B Prime Vendor Program. We want to ensure that the Medicare program pays for specified covered outpatient drugs, purchased under the 340B Drug Pricing Program, at a reasonable payment amount to ensure access to care is maintained, prudent payers of taxpayer dollars, and ensure that Medicare beneficiaries can also stretch their scarce resources. MedPAC has consistently stated that Medicare should institute policies that improve the program’s value to beneficiaries and taxpayers. We believe that utilizing the authority granted under Section 1833(t)(14)(D)(ii) is a step forward in increasing value to the program while being cognizant of the constraints to the program. In the March 2019 Report to The Congress MedPAC noted in part that outpatient payments increased in part due to rapid growth in Part B drug spending.

The latest form for Hospital Survey for Specified Covered Outpatient Drugs (SCODs) (CMS-10709) expires 2021-10-31 and can be found here.