Comparison of 4th Quarter 2009 Part B Drug ASPs/AMPs
The OIG’s latest report comparing Medicare Part B drug ASPs and AMPs found 35 Healthcare Common Procedure Coding System (HCPCS) codes with ASPs that exceeded AMP by at least 5% in the fourth quarter of 2009. If reimbursement for these 35 codes had been based on 103% of the AMPs during the second quarter of 2010, Medicare spending would have dropped by $4.3 million in that quarter alone. The OIG could not compare ASPs and AMPs for 62 other HCPCS codes because AMP data were not submitted for any of the drug products used to calculate reimbursement. Manufacturers for 16% of those drugs had Medicaid drug rebate agreements that required submission of AMP data. The OIG notes it will continue to work with CMS to evaluate and pursue appropriate actions against manufacturers that fail to submit required data. The report is available here.
