OIG Calls for CMS to Improve Medicare Part B Payment Accuracy

The US Office of the Inspector General (OIG) released a recommendation for the Centers for Medicare & Medicaid Services (CMS) to work on better internal processes to improve the accuracy of Medicare Part B drug payment data. The OIG found notable gaps in the agency’s processes for drug payment tracking data and concluded that CMS was unable to calculate prices for 8 percent of drugs at least once over the observed period, 2016-2020.

According to Zachary Brennan, “In general, Medicare pays healthcare providers for most Part B drug codes on the basis of average sales prices (ASPs). Under the ASP payment methodology, the Medicare payment for a Part B drug code is 106% of the volume-weighted ASP for the Part B drug code.”

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(Source: Endpoints News, January 3^rd, 2022)