In a recent report, “Least Costly Alternative Policies: Impact on Prostate Cancer Drugs Covered Under Medicare Part B,” the OIG suggests that CMS consider seeking legislative authority to implement LCA policies for Part B drugs under certain circumstances. By way of background, between 1995 and 2010, Medicare subjected certain Part B prostate cancer drugs to LCA payment policies, under which reimbursement for a group of “clinically comparable” products were based on that of the least costly drug. Part B drug LCA policies were discontinued in April 2010 due to a court ruling that the use of an LCA policy was not authorized under the Medicare statute. In response to a Congressional request to examine the impact of the LCA policy withdrawal, the OIG examined payment between the beginning of the third quarter of 2010 and the end of the second quarter of 2011 for luteinizing hormone-releasing hormone (LHRH) agonists used to treat prostate cancer. The OIG estimates that if LCA policies for LHRH agonists had not been rescinded, Medicare spending would have been cut by $33.3 million over one year (from $264.6 million to $231.3 million). While the OIG found that utilization patterns shifted in favor of certain costlier products after the LCA policy was withdrawn, overall utilization of LHRH agonists to treat prostate cancer has been decreasing. The OIG concludes that “LCA policies may be a useful tool for conserving taxpayer funds, provided that patients retain access to appropriate care, but are not likely to be restored without legislative action.”