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 released an updated notice Nov. 20 on the processing of Medicare provider claims impacted by the government…
Headline
The Medicare Part A deductible for inpatient hospital services will increase by $60 in calendar year 2026 to $1,736, the Centers for Medicare & Medicaid…
Headline
The 43-day government shutdown ended last night when President Trump signed a funding bill into law, hours after the House passed the measure by a 222-209 vote…
Headline
A new report from KFF reveals that Medicare Advantage enrollees had access to just 48% of the physicians available to Traditional Medicare beneficiaries in…
Headline
The AHA Oct. 23 recommended changes to the Centers for Medicare & Medicaid Services’ Wasteful and Inappropriate Services Reduction model to address…
Headline
The Centers for Medicare & Medicaid Services has released an operational guide for Medicare-enrolled providers and suppliers on the Wasteful and…