Summary
Physicians who administer in office drugs under Medicare Part B are not receiving the full ASP (Average Sales Price) + 6%% that was mandated in the MMA 2003 legislation, due to a flaw in the formula used to calculate ASP. Included in the formula that calculates ASP are prompt pay discounts and insurance company rebates which reduce the reimbursement for drug acquisition to average private practice physicians.
The prompt pay discount and rebates decrease reimbursement on infusion drugs to an average of only 1-2% above the acquisition cost rather than the intended 6%, insurance companies and wholesale distributors benefit from these discounts, not physicians.
Fortunately Rep. Ed Whitfield (R-KY) and Gene Green (D-TX) have introduced legislation to address this problem. Contact your members of Congress and ask them to support H.R. 905 to eliminate the ASP and increase the reimbursement to what was originally intended.
Visit the ACR Legislative Action Center to contact your legislators.
