ODACS submission period ends March 31, 2026.
Section 1833(t)(14)(D)(ii) of the Social Security Act requires the Secretary of Health and Human Services (HHS) to periodically conduct surveys of hospital acquisition costs for each specified covered outpatient drug for use in setting payment rates for such drugs. This requirement was reinforced in April 2025 when President Trump issued Executive Order 142273, “Lowering Drug Prices by Once Again Putting Americans First,” which required the secretary to publish a plan to conduct such a survey in the Federal Register.
This plan was announced by the Centers for Medicare & Medicaid Services (CMS) in the Outpatient Prospective Payment System (OPPS) final rule for calendar year (CY) 2026. It stated CMS’ intent to perform the survey to determine the acquisition costs for each separately payable drug acquired by all hospitals paid under the OPPS and to use this information for policymaking beginning with the CY 2027 OPPS proposed rule, expected in late summer. CMS has also voiced its intention to conduct the survey every four years.
CMS has now established an online portal, allowing hospitals to enter applicable acquisition costs for listed drugs and has conducted education on the reporting requirements. CMS has also created a dedicated helpdesk email (OPPSdrugsurvey@cms.hhs.gov) to help hospitals with technical issues related to the survey.
What will hospitals report?
After registering, hospitals will report units purchased and net costs inclusive of all discounts, rebates, and other price concessions for separately payable drugs purchased for outpatient use and paid under OPPS at the 11-digit outer National Drug Code (NDC) level. Units and net costs will be reported separately for 340B and non-340B drugs acquired from July 1, 2024, through June 30, 2025. The survey submission period runs from January 1, 2026, through March 31, 2026 (11:59 p.m. EST).
The survey instructs hospitals to incorporate all rebates and discounts in their acquisition cost for each NDC, including discounts directly applicable to an individual NDC as well as those discounts that are not necessarily linked to a single NDC, such as those linked to purchases over a certain period, wholesaler discounts, and those provided under a Group Purchasing Organization.
Are hospitals required to submit the survey?
There has been much discussion as to whether hospitals are “required” to complete the drug acquisition cost survey. CMS stated in the final rule “that section 1833(t)(14)(D) of the Act does not itself mandate specific consequences either on CMS for failing to design the survey it describes or on hospitals for failing to respond to that survey.”
CMS further addresses how it might interpret non-responses to the survey by including proposals that indicate non-responding organizations may face significant future reimbursement consequences. Proposals include
- Assuming that hospitals that do not respond to the survey have lower acquisition costs than their otherwise similar counterparts
- Using the lowest acquisition cost reported among otherwise similar responding hospitals as a proxy for the average acquisition costs for hospitals that do not respond to the survey
- Using supplemental data sources to inform average acquisition costs for hospitals without cost acquisition survey data, including pricing from the Federal Supply Schedule (FSS); 340B ceiling price; or average sales price (ASP) plus 6%, zero percent, or another percentage
- Concluding that hospitals that do not report their drug acquisition costs lack meaningful additional, marginal costs related to their acquisition of these drugs and their drug costs should not be paid separately but rather should be packaged into the payment for the associated service
Additionally, CMS has reiterated in recently published FAQs that it is considering reasonable assumptions in the event a hospital does not adhere to the statute, including how those assumptions might be reflected in that hospital’s future payment rates.
How should hospitals proceed?
With the reporting period ending March 31, 2026, hospitals should work with their legal counsel and finance staff to develop their reporting strategy and give consideration to the impact of potential consequences for failing to report the requested survey data.
PYA has more than 40 years experience helping hospitals manage regulatory and reporting requirements.
