Why is Medicare Still Using 2003 AWPs for Some Drugs?

from tHEORetically Speaking: The HealthEconomics.Com Blog at http://bit.ly/2gHk0YF on November 30, 2016 at 02:53PM

The use of average wholesale prices (AWPs) is a flawed payment benchmark that does not reflect real-world prices, so why is Medicare’s reimbursement methodology still using 2003 AWPs for some drugs? For some unclear reason, Congress exempted a few dozen durable medical equipment (DME) infusion drugs from the implementation of the 2005 Average Sales Price (ASP) law, which was passed to better align reimbursement amounts with costs. This has led to difficulties finding providers willing to accept Medicare payments. Learn more about these issues and the suggested path forward here. (Source: David Tawes and Marta Wosinska, HealthAffairsBlog, 11/21/16)