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APA WF# 24-08 Biosimilar Reimbursement

These rule changes are currently in effect as Emergency Rules and must be promulgated as Permanent Rules.

These revisions align reimbursement for certain biosimilar products with the Medicare Part B fee schedule. The Inflation Reduction Act (2022) included a provision directing Medicare Part B to increase reimbursement for certain biosimilar products from Average Sales Price (ASP) + 6% to ASP + 8%. These revisions replace specific references to ASP + 6% with language indicating payment will match Medicare Part B’s fee schedule.

Please view the circulation document here: APA WF # 24-08 and submit feedback via the comment box.

Circulation Date: 12/2/2024

Comment Due Date: 1/6/2025

Public Hearing: 1/6/2025

Board Meeting: 1/15/2025

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After you submit your comment, you should be re-directed to a confirmation page. If you are not, please submit your comment through e-mail to federal.authorities@okhca.org.

Please note that all comments must be reviewed and approved prior to posting. Approved comments will be posted Monday through Friday between the hours of 7:30 a.m. – 4 p.m. Any comments received after 4 p.m. will be posted on the following business day.

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Last Modified on Dec 01, 2024
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