In its proposed rule implementing changes to the Medicare Outpatient Prospective Payment System, CMS has proposed to reduce payments to hospitals for separately payable drugs that are eligible for discounts under the 340B Drug Pricing Program.  Specifically, CMS would reduce payments from average sales price + 6 percent, to average sales price minus 22.5%– MedPAC’s estimate for the minimum average discount under the 340B program.  CMS has considered but rejected the idea of changing Medicare reimbursement for 340B hospitals in past rules.