Will this Congress Correct ASP Reimbursement?

Good news this week in the ongoing struggle to clarify reimbursement of drugs administered in the physician office and outpatient setting. Specifically, Congressmen Whitfield (R-Ky.) and Green (D-Texas) introduced H.R. 905 a bill to amend part B of title XVIII of the Social Security Act to exclude customary prompt pay discounts from manufacturers to wholesalers from the Average Sales Price (ASP) for drugs and biologicals under Medicare.

If passed, this legislation would be one important step to improving the consistency, accuracy and adequacy of reimbursement for infused and injected drugs administered in the physician office and clinic settings. The change is particularly important since ASP is now used as a basis for reimbursement by most payers, not just Medicare. This is one of several key changes Congress can make to correct and improve reimbursement for outpatient treatments and support patient access to care.