Tag: Average Manufacturer Price

WASHINGTON – Eight drug codes met CMS’s price substitution criteria in the first quarter of 2022 by exceeding the 5% threshold for two consecutive quarters or three of the previous four quarters, according to a new Office of Inspector General report. The OIG is providing the eight drug codes to CMS for its review. The OIG says CMS should review the information to pursue price substitutions that would limit excessive payments for Part B drugs. To conduct the study, the OIG obtained average...

WASHINGTON – Seven drug codes met CMS’s price substitution criteria by exceeding the 5% threshold for two consecutive quarters or three of the previous four quarters, according to an update from the Office of Inspector General. If the OIG finds that the average sales price for a drug exceeded the average manufacturer price by a certain percentage – currently 5% – the Social Security Act directs the secretary of Health and Human Services to substitute the ASP-based payment...

WASHINGTON - Seven codes for Medicare Part B drugs met CMS's price substitution criteria by exceeding the 5% threshold for two consecutive quarters or three of the previous four quarters, according to a new report from the Office of Inspector General. The OIG is providing the seven codes to CMS for its review. It says CMS should review this information to determine whether or not to pursue price substitutions that would limit excessive payments for Part B drugs. The OIG conducted its study by obtaining...