The CMS has proposed new rules for how Medicare pays for certain drugs that are administered at doctors' offices or otherwise on an outpatient basis. The CMS is proposing four approaches to paying for drugs: paying the same price as private insurers; discounting at 10% to 20% from the average wholesale price, or AWP; using existing market-based prices; and establishing a competitive bidding process and requiring drug companies to report their average sales prices. The CMS currently pays at 95% of the AWP, which the agency says is inflated. The CMS said doctors purchase drugs at prices that are substantially lower than the AWP. The CMS is also proposing to increase payments to physicians for the administration of cancer drugs. The payments would be based on practice expense survey data by the American Society of Clinical Oncology. The agency would increase payments for multiple chemotherapy treatments to a patient on the same day. The rules will be published in the Federal Register on Aug. 20. The CMS will take public comments on the proposal until Oct. 14. -- by Tony Fong
CMS proposes AWP changes
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