OIG reports issues with licensure, infusion payments

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Thursday, December 1, 2016

WASHINGTON – Incomplete and inaccurate data allowed some suppliers in Round 2 of competitive bidding to be awarded contracts, says the Office of Inspector General.

In its Semiannual Report to Congress, the OIG reveals that an audit of 146 suppliers revealed that 63 did not meet all licensure requirements and an additional 14 needed to be further researched by CMS and its contractors. In the report, the OIG also reiterated its recommendation that CMS switch from an average wholesale price model to an average sales price model for DME infusion drugs. Under the AWP model, payments continue to be misaligned with drug costs, says the OIG. CMS could also include DME infusion drugs in the competitive bidding program, according to the report.