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Tag: average sales price


Also Noted

OIG: Part B drugs exceed AMP threshold 

February 18, 2021HME News Staff

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...

ASP, average sales price, Part B drugs


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OIG provides latest pricing update on Part B drugs

November 18, 2020HME News Staff

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...

average manufacturer price, average sales price, Part B drugs, pricing


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OIG recommends CMS review Part B drug prices

November 21, 2019HME News Staff

WASHINGTON - The average sales price for 11 drug codes for the second quarter of 2019 exceeded the average manufacture price by 5% or more for two consecutive quarters, according to a new report from the Office of Inspector General. Another 11 codes exceeded the 5% threshold in the second quarter, but did not meet other price-substitution criteria. When the ASP exceeds the AMP by 5%, the Department of Health and Human Services substitutes the ASP-based amount with a lower calculated rate, either...

average sales price, Part B drugs


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OIG recommends CMS review Part B drug prices

May 16, 2019HME News Staff

WASHINGTON - The average sales price for 10 drug codes for the fourth quarter of 2018 exceeded the average manufacture price by 5% or more for two consecutive quarters, according to a new report from the Office of Inspector General. Another five drug codes exceeded the AMP by at least 5% during the quarter but did not meet other price substitution criteria. When the ASP exceeds the AMP by 5%, the Department of Health and Human Services substitutes the ASP-based amount with a lower calculated rate,...

ASP, average sales price, Part B drugs


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Specialty Providers

Deadline to sign infusion letter looms

January 19, 2017HME News Staff

WASHINGTON - The National Home Infusion Association seeks signatures for a letter that urges Congress to align the effective dates of switching to an average sales price reimbursement model for Part B infusion drugs.In the letter, addressed to Senate Majority Leader Mitch McConnell, Senate Minority Leader Charles Schumer, House Speaker Paul Ryan and Democratic Leader Nancy Pelosi, the association requests “quick action” to ensure beneficiaries have access to services, equipment and drugs.“The...

average sales price, national home infusion association, Part B infusion drugs


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News

In brief: Two senators back bid bill, groups seek vent changes

April 8, 2016HME News Staff

WASHINGTON - HME stakeholders have added two co-sponsors to a bill in the Senate that would delay a second round of Medicare reimbursement cuts slated for July 1.Sens. Debbie Stabenow, D-Mich., and James Lankford, R-Okla., signed on to S. 2736 on April 6. They join 15 other senators, a mix of Democrats and Republicans.The bill, introduced by Sens. John Thune, R-S.D., and Heidi Heitkamp, D-N.C., on March 17, would delay the cuts slated for non-competitive bidding areas from July 1, 2016, to Oct. 1,...

average sales price, Brightree, insulin, ncart, nrrts, ResMed, RESNA, vent NCD


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ASP: Budesonide takes a dive

April 6, 2016HME News Staff

BALTIMORE - Second quarter payments for respiratory drugs are up in most cases, with the exception of Budesonide (J7626), which decreased sharply, down nearly 73 cents per dose. Perforomist (J7606) saw the biggest increase, up 41 cents to $9.82 per dose, according to the latest average sales price (ASP) figures. Brovana (J7605) increased 24 cents to $8.50 per dose. Albuterol (J7613) and ipratropium (J7644) stayed fairly flat, at 12.5 cents per dose and 10.5 cents per dose, respectively.

albuterol, average sales price, respiratory drugs


Specialty Providers

NHIA pushes back on ASP

July 27, 2015Theresa Flaherty, Managing Editor

WASHINGTON - The House of Representatives on June 17 passed a bill that included a provision that would switch payment for Part B home infusion drugs to an average sales price model—a model that is unsustainable, say infusion stakeholders.“The services that are associated with Part B infusion drugs are not reflected in the policy lawmakers are moving forward,” said Kendall van Pool, vice president of legislative affairs for the National Home Infusion Association. “If this...

average sales price, national home infusion association, NHIA


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In brief: Judge favors Lincare in whistleblower lawsuit, neb-med payments are up and down

July 17, 2015HME News Staff

MIAMI - A federal judge has ruled that two former Lincare employees failed to prove the provider violated Medicare telemarketing rules.U.S. District Judge Kathleen Williams on July 10 issued a partial summary judgment that freed Lincare from most of the charges outlined in a whistleblower lawsuit accusing the provider of violating the False Claims Act.The plaintiffs had argued that Lincare and its subsidiary, Diabetic Experts, violated Medicare rules by using improper sales leads to make unsolicited...

ActivStyle, average sales price, lincare, Univita Health


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ASP: Up for brand name neb-meds

July 17, 2015HME News Staff

BALTIMORE - Third-quarter payments for respiratory drugs are up and down. Brand name drugs Brovana (J7605) and Perforomist (J7606) were up 16 cents and nearly 44 cents to $7.20 and $8.48 per dose, respectively. Payments for budesonide (J7626) were down nearly 38 cents to $5.20 per dose and payments for albuterol (J7613) were cut in half to 13.5 cents per dose. Ipratropium (J7644) stayed relatively flat at just under 11 cents per dose.

average sales price, neb meds