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Saturday, February 8, 2014

United States Department of Health and Human Services ("HHS") Office of Inspector General 2014 Work Plan Includes Payment for Compounded Drugs

Prescription Drugs
The 2014 Plan summarizes new initiatives targeting the 340B Program as well as average sales price reporting and covered uses for Part B drugs.
  • Part B Payments for 340B Program Drugs. New for FY 2014, the OIG will determine how much Part B spending could be reduced if Medicare were able to share in the savings for 340B-purchased drugs. The OIG will calculate the amount by which average sales price-based payments exceed 340B prices and estimate potential savings on the basis of various shared-benefit methodologies.
  • Payment for Compound Drugs. The OIG will examine Medicare Administrative Contractors' policies and procedures for reviewing and processing Part B claims, as well as appropriateness of claims for compounded drugs.
In addition, the OIG will determine the potential effect on average sales price reporting if all manufacturers of Part B drugs were required to submit average sales prices to CMS. The OIG will also review oversight actions by CMS and claims processing contractors to ensure payments for Part B drugs meeting coverage criteria.

quoted from here

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