Corporate Compliance

OIG finds ASPs too high for 41 drugs

Healthcare Auditing Weekly, January 6, 2009

The average sales prices (ASP) for 41 drugs exceeded the average manufacturer prices (AMP) by at least 5% in the first quarter of 2008, according to an OIG audit.
 
Of the 312 drugs with complete AMP data in the first quarter of 2008, 16 met the 5% threshold under the revised ASP payment methodology. Of the 129 drugs with only partial AMP data, 25 had ASPs that exceeded the AMPs by at least 5% in the first quarter of 2008. If reimbursement amounts for these 41 drugs had been based on 103% of the AMPs, Medicare would have saved $7.8 million during the third quarter of 2008 alone.
 
Under the Social Security Act, the OIG compares ASPs to AMPs. If OIG finds the ASP for a drug exceeds the AMP by a certain percentage (currently 5%), the Secretary of the Department of Health and Human Services may disregard the ASP for the drug when setting reimbursement amounts.

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