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OIG Study Finds Higher Drug Supplying and Dispensing Fees in Part B than Part D and Medicaid

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A recent Office of Inspector General (OIG) report analyzed 2011 Medicare Part B spending on dispensing fees for inhalation drugs administered through durable medicare equipment and supplying fees for certain immunosuppressive, anticancer, and antiemetic drugs. Overall, Part B spent almost $133 million on the dispensing and supplying fees for these drugs. The OIG estimated that if Part B had used average Part D payment rates, it would only have spent $22 million on dispensing and supplying fees. Similarly, using average State Medicaid rates, Part B would only have paid $26.6 million.

Ultimately, the OIG recommended that CMS pursue policies bringing Part B payment rates for dispensing and supplying fees closer to those of Part D and Medicaid. CMS did not agree with this recommendation, and requested additional information on the activities and costs associated with providing the studied drugs. The OIG declined to explore the request, maintaining that pharmacists did not identify additional services or requirements for providing these drugs to Part B beneficiaries as opposed to Part D and Medicaid beneficiaries.




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