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Medicare Drug Price Substitution For Part B Proposed Again By CMS

This article was originally published in The Pink Sheet Daily

Executive Summary

The proposal to reimburse less for drugs that exceed a price substitution threshold, first made last year but never finalized, is part of the Physician Fee Schedule proposed rule for 2012.

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Savings From Part B Rx Price Substitution Are Small, But Worth Getting – OIG

HHS Office of Inspector General says CMS’ price substitution policy for drugs exceeding 5% in ASP/AMP pricing differential would have saved Medicare $7 million in 2011, less than a tenth of a percent of total Part B drug spending, CMS does not concur with OIG recommendations to help increase savings.

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