decisionhealth Newsletters, Part B News - 2006 Issue 3 (March)
OIG: ASP reimbursements calculated wrong
Subscribe or sign in to view the full article.
Article Overview
This premium article covers an OIG finding that Medicare reimbursement amounts for drugs billed under the average sales price methodology were affected by how CMS calculated pricing inputs tied to HCPCS billing units and NDC-level manufacturer data. It is relevant to pharmacy billing, Medicare payment policy, and compliance staff who track drug reimbursement methodology and agency responses to payment accuracy concerns.
Why This Topic Matters
It helps readers understand a reported Medicare payment issue affecting drug reimbursement calculations, the scale of the financial impact, and the broader policy context around CMS pricing methods.
What You Will Learn
- The general issue identified in an OIG report about Medicare drug reimbursement calculations
- How CMS’s average sales price methodology is discussed in relation to HCPCS and NDC data
- The reported impact of the pricing issue on Medicare and providers
- CMS’s response to the OIG findings
Who Should Read This
- Medical coders
- Billing staff
- Compliance professionals
- Pharmacy reimbursement specialists
- Revenue cycle professionals
- Healthcare administrators
Subscribe or sign in to view the full article.
Quick, Current, Complete - www.findacode.com