On July 13, the Centers for Medicare and Medicaid Services, or CMS, released a proposal to reduce Medicare reimbursement for separately payable 340B drugs administered in hospitals from ASP + 6% to ASP – 22.5%. Although this proposed regulation would not affect reimbursement to Ryan White clinics, it sets a dangerous precedent that may embolden other payers. Private payers often try to force Ryan White clinics to accept lower reimbursement for 340B drugs so that the private payer can pocket the 340B savings. This type of discriminatory reimbursement provision thwarts the purpose of the 340B program, which is to help safety net providers stretch their scarce federal resources to reach more patients and offer more comprehensive services.   The CMS proposal is on pages 298 – 311 of the proposed rule.