For those of you that have not fully grasped the financial impact of CMS' latest memo mandating the use of Average Wholesale Price when calculating future prescription drug treatment, here is a sobering statistic gleaned from one client's experience.

We calculated the increase from our normal RX calculation methodology to AWP and came up with a $1.4MM differential on the first 17 cases.  And that is without using the infamous donut hole or arbitrary DUR in the initial calculation.

So the question now becomes, is CMS' opinion worth $1.4MM?

Medicare Set-Aside Allocation/Arrangement Recommendations

Submissions to Centers for Medicare and Medicaid Services

Post-Settlement Administration

Pharmacy Benefit Management