- 08
- Apr
- 2009
CMS TO INDEPENDENTLY PRICE AND CALCULATE FUTURE PRESCRIPTION DRUG TREATMENT
On April 3, 2009, the Centers for Medicare and Medicaid Services (CMS) issued a formal memorandum stating that it will start independently pricing future prescription drug treatment costs/expenses in Workers' Compensation Medicare Set-Aside (MSA) proposals beginning June 1, 2009. Per CMS, prescription drug amounts will be independently priced and calculated by CMS using average wholesale price (AWP) for all completed MSA submissions received on or after June 1, 2009, where the future treatment plan for a workers' compensation injury includes prescription drugs. CMS will accept the use of Generic Part D prescription drugs using AWP pricing, when applicable; however, CMS will not use or recognize any other pricing, discounting, or calculation methods when determining the adequacy of the prescription drug amounts in these MSA proposals.
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