Availability of the list of essential medicines considered to be in shortage for the purposes of the recently finalized separate IPPS payment for establishing and maintaining access to essential medicines
On August 1, CMS issued the fiscal year (FY) 2025 Medicare Hospital Inpatient Prospective Payment System (IPPS) and Long-Term Care Hospital (LTCH) Prospective Payment System (PPS) final rule. As part of the final rule, CMS finalized a Separate IPPS Payment for Establishing and Maintaining Access to Essential Medicines.
Effective for cost reporting periods beginning on or after October 1, eligible hospitals may receive payments under the IPPS to cover the additional costs of voluntarily maintaining a 6-month buffer stock of one or more of 86 essential medicines.
Providers impacted
- Small, independent hospitals not part of a chain organization with fewer than 100 beds
CMS will post on its website a listing of the drugs that are or are not in shortage on or about the beginning of each calendar year quarter. The purpose of this is to establish eligibility for separate payment for the costs of creating and maintaining these stocks. Updates to the list of medicines considered to be in shortage will take effect on the first day of each respective calendar year quarter.
Note: Medicare will not pay for a newly established buffer stock of an essential medicine if that medicine is currently in a shortage status.
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