tci Part B Insider - 2003 Issue 6

DRUG PRICING: CMS Seeks Alternative To Inherent Reasonableness For Drugs

The trouble with bluffs is they wear off eventually. The Centers for Medicare & Medicaid Services has been threatening since last year to tackle Medicare drug prices administratively if Congress doesn't address the issue. But Congress has taken a pass on reforming the average wholesale price methodology, and still CMS hasn't acted. Now CMS is once again threatening to take action on its own, but its less clear than ever what the agency plans to do. For one thing, the agency isn't saying when it'll act. "We have said publicly if Congress doesn't fix the AWP-based payment system legislatively...

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