CMS proposes ASP+4% for hospital outpatient drugs

Executive Summary

CMS is proposing to lower the rate at which hospital outpatient drugs are reimbursed from the current average sales price plus 5 percent to ASP plus 4 percent for 2009. According to the outpatient prospective payment system proposed rule for 2009, released July 3, CMS is proposing "to continue our policy of making a combined payment for the acquisition and pharmacy overhead costs of separately payable drugs and biologicals at an equivalent average ASP-based amount calculated based on our standard methodology of estimating drug costs from claims." The agency added that ASP plus 4 percent "is the best currently available proxy for average hospital acquisition cost and associated pharmacy overhead cost.