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CMS Methodology, Not Industry Complaints, Brings Proposed Hospital Part B Outpatient Drug Reimbursement Back To ASP+6% in 2011

This article was originally published in The Pink Sheet Daily

Executive Summary

Agency calls rate a "coincidental outcome" in its proposed update to the Medicare hospital outpatient prospective payment system for 2011.

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Medicare Default Payment Of ASP+6% For Hospital Outpatient Drugs Has Industry Support

CMS says default for reimbursement of Medicare Part B drugs used in hospital outpatient settings will be average sales price plus 6% as it seeks to improve methods of calculating a proper reimbursement rate based on data provided by hospitals. The rate has fluctuated year-to-year, from ASP+4% to ASP+6%, under the previous formula.

Part B Hospital Drug Reimbursement Set At ASP Plus 5 Percent In Final Rule

CMS had proposed an increase to ASP plus 6% for drugs used in the hospital outpatient setting in draft rule. Agency also is not moving ahead on Part B price substitution plan for drugs used in the physician office setting.

Part B Hospital Drug Reimbursement Set At ASP Plus 5 Percent In Final Rule

CMS had proposed an increase to ASP plus 6% for drugs used in the hospital outpatient setting in draft rule. Agency also is not moving ahead on Part B price substitution plan for drugs used in the physician office setting.

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