Question:
Can you tell me more about the OIG’s recommendation to strengthen oversight of Part D payments for compounded topical drugs?
Answer:
According to The Solutions to Reduce Fraud, Waste, and Abuse in HHS Programs: OIG’s Top Recommendations 2019 compendium, “CMS issued a memorandum to plan sponsors that clarified Part D policies for coverage of compounded topical drugs and use of utilization management tools.” The agency did some pharmacy analysis but has yet to give limited training for plan sponsors on compounded topical drugs. This is in part because CMS has yet to complete follow-ups for pharmacy and prescribers that were identified by the Office of the Inspector General (OIG).
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Fee schedules, relative value units, conversion factors and/or related components are not assigned by the AMA, are not part of CPT, and the AMA is not recommending their use. The AMA does not directly or indirectly practice medicine or dispense medical services. The AMA assumes no liability for data contained or not contained herein.
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