January 4, 2023
Payers
  • The U.S. Department of Health and Human Services (HHS) Office of the Inspector General (OIG) released a report revealing that Medicare lost out on millions of potential savings due to spotty oversight of the average sales price (ASP) of medications. According to the report, even though the Centers for Medicare & Medicaid Services (CMS) has an established procedure to oversee data on the ASP of medications, the agency lacks a process to review the manual analysis. Invalid or missing ASP data resulted in the CMS being unable to determine payment amounts for 8 percent of products between 2016 and 2020. Nearly a quarter of drug codes were missing ASP data for one or more specific drugs within that code in at least one quarter during that span. (Articles here and here)