March 25, 2009
Previously published on February 27, 2009
On February 27, 2009, the OIG issued a report comparing Medicare Part D and Medicaid pharmacy reimbursement amounts for selected drugs at the national level. The OIG found that the average Part D and Medicaid pharmacy reimbursement amounts were similar for most of the selected drugs. There was less than a five percent difference between Part D and Medicaid amounts. Additionally, the average unit ingredient costs were very similar.
The OIG also found that Medicaid pharmacy reimbursement amounts generally exceeded the average Part D reimbursement amounts for selected multiple-source drugs. The Medicaid ingredient cost exceeded the average Part D ingredient cost for more than half of the multiple-source drugs reviewed. The Medicaid dispensing fee exceeded the average Part D dispensing fee for these multiple-source drugs by at least 55 percent.
CMS agreed with the OIG’s findings.
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