CMS proposes Part B reimbursement rule for biosimilars

CMS proposed a rule under which all biosimilars for a given reference product covered under Medicare Part B would be issued the same Healthcare Common Procedure Coding System (HCPCS) code, and would therefore be reimbursed at the same rate.

CMS also proposed that newly approved biosimilars be reimbursed at 106% of their wholesale acquisition cost (WAC) until Medicare has enough data to compute an average sales price (ASP). Under the current CMS policy on Part B drugs, physicians are reimbursed the ASP for the biosimilar plus 6% of the ASP for the reference product (see BioCentury, April 13). ...