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CMS Payment Provisions Part B Drugs/Payment for Biosimilar Biological Products
CMS.gov (10/30/2015)
The Centers for Medicare & Medicaid Services (CMS) on Oct. 30 issued a final rule that updates payment policies, payment rates, and quality provisions for services provided under the Medicare Physician Fee Schedule (PFS) on or after Jan. 1, 2016. This final rule is part of a broader strategy by the Obama administration to encourage better care, more efficient spending, and improved patient health. PFS pays for services furnished by health-care providers, including office visits, surgical procedures, diagnostic tests, and therapy services. CMS has finalized a proposal to update its 2010 regulations regarding payment for biosimilars under Medicare Part B. The update clarifies that the payment amount for a biosimilar is based on the average sales price of all biosimilar biological products within the same billing and payment code.
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