- “In updating our analysis, we found that Medicare expenditures for DME infusion drugs could have been reduced by $251 million in an 18-month period if the ASP-based payment methodology recommended by OIG had been implemented in April 2013 (i.e., the quarter after our earlier report was issued).”
- According to the inspector general report: “If payment amounts for DME infusion drugs had been based on ASPs rather than decade-old AWPs between the second quarter of 2013 and the third quarter of 2014, total Medicare Part B spending would have decreased by 35 percent (from $712 million to $461 million), a reduction of $251 million.”
- The report concluded: “Under this methodology, providers are being reimbursed for many drugs at double their costs, while recouping only half of their costs for other drugs.”
- “VA statistics show that the number of patients facing long waits has not declined, even after Congress gave the department an extra $16.3 billion last summer to shorten waits for care.”
- Almost 900,000 completed medical appointments at various VA medical locations from August, 2014 through February, 2015, failed to meet the VA’s timeliness goal, a goal that requires patients be seen within 30 days.
- More than 25% of those appointments were not met within 60 days.
- Despite the urgency of the President and Congress, since last summer, the number of veterans waiting more than 30 or 60 days for non-emergency care has largely stayed flat, i.e. no improvement, but the number of medical appointments that take longer than 90 days to complete has nearly doubled.
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