CMS should strengthen oversight of Part D payments for compounded topical drugs to prevent fraud, waste, and abuse while maintaining appropriate access. The OIG issued two reports identifying significant increases in Part D spending for compounded drugs, noting that spending increased from $13.2 million in 2010 to $232.5 million in 2016. As a result, the OIG recommended that CMS should strengthen oversight of compounded drugs. In response, CMS issued a HPMS memorandum reminding PDPs of Part D policies for coverage of compounded topical drugs and use of utilization management tools. However, the OIG does not believe it is sufficient, as CMS has not yet completed follow-up on the pharmacies identified by OIG.
read more at https://www.natlawreview.com/article/oig-urges-cms-to-implement-solutions-to-reduce-fraud-medicare-part-c-and-part-d
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