Medicare Patients Could Save $900 Under New 2027 Rules
Summary
CMS says new 2027 Medicare payment rules could save some Original Medicare beneficiaries an average of $900 on qualifying drugs given in hospital outpatient departments. The rules also change payments for discounted 340B drugs, reduce some imaging payments, and allow more procedures to take place in outpatient settings.Key Facts
- The projected $900 average saving applies to eligible Original Medicare beneficiaries who receive qualifying drugs in hospital outpatient departments.
- CMS estimates the changes will reduce patients’ combined costs by $1.1 billion and Medicare spending by $4.35 billion in 2027.
- Under the revised 340B payment rule, Medicare will reimburse qualifying hospitals for drugs bought through the program at 28 percent below the drugs’ average sale price, replacing a rate of 6 percent above that price.
- The 340B program lets eligible hospitals and health providers buy outpatient drugs from manufacturers at discounted prices.
- CMS estimates lower payments for certain imaging services at off-campus hospital outpatient departments will save beneficiaries and taxpayers about $260 million in 2027.
- The rule removes 637 more services from Medicare’s inpatient-only list, allowing those treatments to be performed in outpatient settings.
- Medicare Part B generally covers some drugs administered by health workers, and patients typically pay 20 percent of the cost after meeting their deductible.
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