This input helped inform the specifications for the chronic condition episode-based measure framework, which serves as the framework for the chronic condition episode-based measures (that is, Prostate Cancer, Rheumatoid Arthritis, CKD, ESRD, and Kidney Transplant Management episode-based measures) developed in Wave 5 and being proposed in this proposed rule
CMS must use the methodology set forth in this section to calculate the inflation-adjusted beneficiary coinsurance and associated adjusted Medicare payment percentage for Part B rebatable drugs as set forth in 410.152(m), 419.41(e), and 489.30(b)(6) of this chapter
In accordance with the proposed regulation at 428.401(d) to reconcile the rebate amount in the case of revised information, including a reconciliation of the total number of units detailed at proposed 428.401, CMS is soliciting comments on providing covered entities with additional time to submit data to reflect a revision to the 340B determination of claims with dates of service throughout an applicable period
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