AWP = $1.4MM Increase in Settlement Value

Medicare Set-Aside Blog on April 24, 2009 | Posted by

      

For
those of you that have not fully grasped the financial impact of CMS’ latest memo mandating the use of Average Wholesale Price when calculating future
prescription drug treatment, here is a sobering statistic gleaned from one
client’s experience.

 

We
calculated the increase from our normal RX calculation methodology to AWP and
came up with a $1.4MM differential on the first 17 cases.  And that is without using the infamous donut
hole or arbitrary DUR in the initial calculation.

 

So
the question now becomes, is CMS’ opinion worth $1.4MM?

 

 

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