OIG: CMS could lower Medicare payment for 15 Part B drugs
In a report this week, the Department of Health and Human Services’ Office of Inspector General identified 15 drug codes that in third-quarter 2022 met the Centers for Medicare & Medicaid Services’ criteria for substituting a lower Medicare price for certain Part B drugs. This means CMS may substitute either the widely available market price or 103% of the Average Manufacturers Price, whichever is less, when pricing these drugs, rather than using Average Sales Price plus 6%. The report does not identify the 15 drug codes.
Related News Articles
Headline
The Centers for Medicare & Medicaid Services and the Food and Drug Administration April 23 announced a new pathway to expedite access to certain FDA-…
Blog
In think‑tank reports, like the one released this week by Paragon Health Institute, hospitals are often reduced to abstractions — payment rates, charts,…
Headline
As published April 20, the Department of Justice released an interim final rule in the Federal Register to delay compliance dates for states and local…
Headline
The AHA today released its Health Care Plan Accountability Update, covering the latest developments in Medicare Advantage, legislation and…
Headline
UnitedHealth Group announced plans to expand its Rural Payment Acceleration Pilot to reduce Medicare Advantage payment processing times for…
Headline
A Health Affairs report published April 6 examined how changes in patient cost-sharing liability can impact hospital finances. The study found that…