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Remedy for the 340B-Acquired Drug Payment Policy for Calendar Years 2018-2022 Comment: A commenter supported CMS’s approach to account for the reduction for non-drug items and services to OPPS providers in MA rate calculations starting in 2026. Response: CMS appreciates the support. Comment: A couple of commenters expressed concern about CMS’s approach to account for the 0.5 percent reduction in non-drug items and services to OPPS providers in the MA rate calculations, which CMS has previously referred to as the “340B adjustment.” (See, e.g., 82 FR 59353 through 59371.) They urged that CMS’ MA rate announcement policies have not sufficiently accounted for Part B remedy payments to 340B hospitals for drugs furnished between 2018 and 2022. The commenters believe that CMS’s approach would benefit MA plans and result in MA plans underpaying hospitals for 340B drugs between 2018 and 2022 and again underpaying hospitals for non-drug items and services beginning in CY 2026, and they urged CMS to take alternate measures. A commenter provided the following specific suggestions for CMS to consider: (1) For CMS to directly pay lump sum settlements to 340B hospitals on behalf of MA plans; (2) For CMS to increase the rates paid to MA plans and mandate that the increased payments flow directly from MA plans to 340B hospitals; or (3) For CMS to create a pricer that does not include the decreased conversion factor for non-drug outpatient items and services to be used starting in CY 2026 for approximately 16 years, and to mandate that the pricer be used by MA plans for payments to non- contracted hospitals. Response: CMS appreciates commenters’ feedback on this issue, particularly the specific alternative suggestions. CMS’s approach to developing the CY 2026 MA rates using the 2026 OPPS FFS rate that reflects the 340B Remedy Rule’s 0.5 percent budget neutrality adjustment is consistent with how CMS develops prospective MA rates each year for the Advance Notice and Rate Announcement. CMS is not remedying through this MA rate announcement the policy regarding Medicare Part B payments for 340B-acquired drugs made to providers that it had implemented from 2018-2022. Rather, the Remedy Rule adjusts the CY 2026 FFS rates from what they would be otherwise, which impacts CMS’s estimate of the CY 2026 FFS per capita costs used to develop MA rates. As required by section 1853 of the statute, CMS estimates the per capita FFS costs for CY 2026 to develop MA benchmarks, as preliminarily discussed in the CY 2026 Advance Notice and finalized through this CY 2026 Rate Announcement. Specifically, section 1853(n)(2) of the Act requires that, in determining the payment amount, CMS use the base amount described in section 1853(c)(1)(D), based on 100 percent of FFS costs with adjustments for a rebasing year.