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Tag: Infusion drugs

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OIG tells CMS again: Switch to ASP for infusion drugs

September 8, 2016HME News Staff

WASHINGTON - The Office of Inspector General in a new report reiterates its concerns that, unlike most Part B drugs, Medicare payment amounts for DME infusion drugs are still based on average wholesale prices from 2003. Three years ago, the OIG published a report recommending changes to Medicare payments for DME infusion drugs; however, CMS has continued to reimburse for these drugs at prices that are unrelated to the amounts providers pay to acquire them. The OIG is concerned that paying for the...

Infusion drugs, OIG, Report

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OIG: CMS overpays for infusion drugs

April 23, 2015HME News Staff

WASHINGTON - CMS could have saved $251 million over an 18-month period if it paid for DME infusion drugs using an average sales price methodology, according to a new report from the Office of Inspector General. While most Part B drugs are paid at 106% of the ASP, infusion drugs are paid at 95% of the average wholesale price. Between the second quarter of 2013 and the third quarter of 2014, at least 42% of infusion drugs were paid at amounts that were more than twice their estimated acquisition costs,...

ASP, Infusion drugs

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