OIG: Part B drugs exceed AMP threshold
By HME News Staff
Updated 8:43 AM CST, Thu February 18, 2021
WASHINGTON – Seven codes for Medicare Part B drugs met CMS’s price substitution criteria by exceeding the 5% threshold for wo consecutive quarters or three of the four previous quarters, according to a new report from the Office of Inspector General. To conduct the study, the OIG calculated the volume-weighted average manufacturer’s price for each drug, consistent with CMS's methodology for calculating volume-weighted average sales prices. The OIG is providing the seven drug codes to CMS for review. CMS should review this information to determine whether to pursue price substitutions that would limit excessive payments for Part B drugs.
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