Becker's Healthcare January 4, 2023
CMS needs better strategies to ensure proper oversight of Medicare Part B drug payment calculations, according to a Dec. 3 report from HHS’ Office of the Inspector General.
Medicare members spend about $40 billion every year on Part B prescription drugs and biologicals. CMS uses the manufacturer-reported average sales price for the drug from quarterly sales to calculate provider payments for the drug.
Because drug manufacturers have been able to report inaccurate ASPs, it’s led to incorrect Part B drug payment amounts from CMS, meaning Medicare enrollees may be paying the wrong price for drugs. CMS also said that late ASP submissions also slows its oversight abilities.
According to the OIG, incorrect or missing ASP data can stem from negative...
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