tci Medicare Compliance & Reimbursement - 2003 Issue 8

Pharmaceuticals: EMPIRE STATE JOINS AWP CRUSADE

New York Attorney General Eliot Spitzer joined a half dozen other states in suing drugmakers over one of the hottest compliance hot buttons of recent years: alleged meddling with the average wholesale price that governs Medicare and Medicaid reimbursement. In lawsuits filed Feb. 13, Spitzer accused GlaxoSmithKline and Pharmacia of reporting an inflated AWP and using the difference between the reported price and the amount it actually charged doctors, pharmacists and other health care providers — the so-called “spread” — to induce practitioners to prescribe their drugs. Providers make out well under the practice, since they obtain the...

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