Saturday, August 3, 2019

The OIG Urges CMS to Implement Solutions to Reduce Fraud in Medicare Part C and Part D Thursday, August 1, 2019

CMS should strengthen oversight of Part D payments for compounded topical drugs to prevent fraud, waste, and abuse while maintaining appropriate access. The OIG issued two reports identifying significant increases in Part D spending for compounded drugs, noting that spending increased from $13.2 million in 2010 to $232.5 million in 2016.  As a result, the OIG recommended that CMS should strengthen oversight of compounded drugs.  In response, CMS issued a HPMS memorandum reminding PDPs of Part D policies for coverage of compounded topical drugs and use of utilization management tools. However, the OIG does not believe it is sufficient, as CMS has not yet completed follow-up on the pharmacies identified by OIG. 


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