tci Medicare Compliance & Reimbursement - 2003 Issue 33

Pharmaceuticals: 4 SOLUTIONS TO THE OUTPATIENT DRUG PUZZLE

A new world is at hand for Medicare drug payments.Responding to what the feds worry are billion-dollar abuses of the Medicare program, the Centers for Medicare & Medicaid Services has joined Congress in attempting to overhaul the controversial "average wholesale price" system that sets Medicare payments for outpatient drugs. CMS has not, however, decided on a final solution. Instead, it offered four possible approaches in an Aug. 20 Federal Register notice, and invited comments on the alternatives from the health care community. In a nutshell, the alternatives are as follows: 1. Medicare would pay the same amount for...

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