tci Part B Insider - 2003 Issue 8

DRUG REIMBURSEMENT: CMS Invites Least Costly Alternative for Drugs

Medicare's new Single Drug Pricer doesn't mean that the Centers for Medicare & Medicaid Services has given up on the idea of using inherent reasonableness to cut drug payments, CMS says in a new program memo. The new memo, AB-03-047, also corrects Medicare prices for two drugs, retroactive to Jan. 1. Medicare will reimburse $76 per dose for J1563, injections of intravenous immune globulin, and $16.45 per dose for J1260, dolasetron mesylate. An earlier correction, issued Jan. 14, had reduced the rate for J1563 to $55 per dose. The Jan. 14 correction, issued in a "joint letter,"...

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