Tag Archives: average sales price (ASP)

CMS to Educate Drug Manufacturers on Navigating New ASP Reporting System

CMS is requiring prescription drug manufacturers that report average sales price (ASP) data to use a new automated system, beginning with the second quarter 2018 ASP data submission (due April 30, 2018).  To help manufacturers navigate the new system, CMS is hosting a March 27, 2018 educational call, which will include a question and answer … Continue Reading

GAO, OIG Issue Reports on Medicare Part B Drug Payment Issues

The HHS Office of Inspector General (OIG) and the Government Accountability Office (GAO) recently issued several reports on various Medicare Part B drug reimbursement issues. In a report entitled “Medicare Part B: Data on Coupon Discounts Needed to Evaluate Methodology for Setting Drug Payment Rates,” the GAO assessed the impact of manufacturer coupon programs on … Continue Reading

GAO Calls For Mandatory Medicare Drug ASP Reporting, CMS Verification of Drug Pricing

A recent Government Accountability Office (GAO) report, “Medicare Part B: CMS Should Take Additional Steps to Verify Accuracy of Data Used to Set Payment Rates for Drugs,” questions the reliability of pricing for Medicare Part B drugs reimbursed based on average sales price (ASP). The GAO observes that while CMS performs various electronic checks of … Continue Reading

CMS Posts April 2016 Medicare Part B Drug Files

CMS has posted the payment amounts that will apply to Medicare Part B covered drugs for the second quarter of 2016. CMS notes that average prices for the top Part B drugs increased by 1% compared to the previous quarter, and that “for the most part, average drug prices in the market remain relatively stable.”… Continue Reading

CMS Updates Medicare Part B Drug Pricing Files

CMS has posted its October 2014 update to the Medicare average sales price (ASP) drug pricing files, which contain the payment amounts that CMS will use to pay for Part B covered drugs for the fourth quarter of 2014. CMS notes that prices for the top Part B drugs decreased by 0.4% on average this … Continue Reading

OIG Recommends Expansion of CMS’s Medicare Part B Drug Pricing Substitution Policy

The OIG has issued a report, “Comparing Average Sales Prices and Average Manufacturer Prices for Medicare Part B Drugs: An Overview of 2012,” which assesses CMS’s use of its authority to lower reimbursement for Medicare Part B drugs when a drug’s average sales prices (ASP) exceeds its average manufacturer prices (AMP) or widely available market price … Continue Reading

Updated Medicare Part B Drug Files Released

CMS has posted updated average sales price (ASP) files with payment rates for Part B covered drugs for the first quarter of 2014, based on third quarter 2013 data. According to CMS, average drug prices in the market remain relatively stable, with average prices for the top Part B drugs decreasing by 1.4%.… Continue Reading

CMS Releases Fourth Quarter 2013 Drug ASP Files

CMS has released the October 2013 Medicare average sales price (ASP) file update, which reflects payment amounts be used to pay for Part B drugs for the fourth quarter of 2013. CMS notes that market prices generally remain relatively stable, with average prices for the top Part B drugs decreasing by 0.4% compared to the … Continue Reading

July 2013 Update to Medicare ASP Files

CMS has posted the July 2013 Medicare Part B average sales price (ASP) files, containing the payment amounts that will be used to pay for Medicare Part B covered drugs for the third quarter of 2013. CMS observes that average drug prices in the market generally remain stable, with prices for the top Part B … Continue Reading

OIG Continues to Call on CMS to Implement Medicare Part B Drug Pricing Reforms

For the 29th time, the OIG has issued a report comparing Medicare Part B drug average sales prices (ASP) and average manufacturer prices (AMP), this report covering all of 2011. The OIG again concludes that the Medicare would realize savings if it exercised its authority to lower reimbursement for Part B drugs when the drugs … Continue Reading

OIG Issues Medicare Part B Drug Pricing Report, Calls Out CMS Inaction on Reforms

The OIG has released the most recent in a series of reports comparing Part B drug average sales prices (ASP) and average manufacturer prices (AMP). The latest report (the 28th in the series) compares second quarter 2012 ASPs and AMPs and their impact on Medicare reimbursement for the fourth quarter of 2012. By way of … Continue Reading

CMS Finalizes OPPS, ASC Rates and Policies for 2013

On November 15, 2012, the Centers for Medicare & Medicaid Services (CMS) published its publishing its final rule with comment period updating Medicare payment and other policies for the hospital outpatient prospective payment system (OPPS) and ambulatory surgical centers (ASCs) for CY 2013. The rule also updates Medicare quality reporting program policies and various other Medicare … Continue Reading
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