OIG spotlights home infusion payments in report to Congress

Wednesday, December 2, 2015

WASHINGTON – Medicare could have reduced payments for home infusion drugs by $251 million over an18-month period if it used an average sales price methodology, the Office of Inspector General said in its Semiannual Report to Congress. The OIG, which has recommended that Medicare switch from an average wholesale price to an ASP model, found that “at least 42% of DME infusion drugs had Medicare payment amounts that were more than twice their estimated acquisition costs.” The OIG reported the same findings in April but noted it had not factored in the cost of services for providing home infusion therapy.