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Background Section 10501(i)(3)(A) of the Affordable Care Act added section 1834(o) of the Act to establish a payment system for the costs of FQHC services under Medicare Part B based on prospectively set rates

For the first three quarters of 2026, we are proposing use an estimation policy that would remove a percentage of units from the total number of units used to calculate the total rebate amount to remove 340B units from Part D drug inflation rebate calculations

We could seek to establish a final policy in RHCs and FQHCs once a final policy is determined under the PFS, to avoid confusion since they are taking an incremental approach at the code level for CY 2025

44 Despite these effects, randomized, controlled trials have found no significant increase in the incidence of cardiovascular events or mortality among patients with cardiovascular disease receiving NRT when compared with that of patients receiving placebo