Editing Medicare (United States) (section)

====Office medication reimbursement====
[[Chemotherapy]] and other medications dispensed in a physician's office are reimbursed according to the Average Sales Price (ASP),<ref>{{Cite web |url=http://questions.cms.hhs.gov/cgi-bin/cmshhs.cfg/php/enduser/std_adp.php?p_faqid=3303 |title=Archived copy |access-date=April 11, 2015 |archive-url=http://webarchive.loc.gov/all/20150411130719/http://questions.cms.hhs.gov/cgi-bin/cmshhs.cfg/php/enduser/std_adp.php?p_faqid=3303 |archive-date=April 11, 2015 |url-status=dead }}</ref> a number computed by taking the total dollar sales of a drug as the numerator and the number of units sold nationwide as the denominator.<ref>{{Cite web |url=http://questions.cms.hhs.gov/cgi-bin/cmshhs.cfg/php/enduser/std_adp.php?p_faqid=4758 |title=Archived copy |access-date=April 11, 2015 |archive-url=http://webarchive.loc.gov/all/20150411130725/http://questions.cms.hhs.gov/cgi-bin/cmshhs.cfg/php/enduser/std_adp.php?p_faqid=4758 |archive-date=April 11, 2015 |url-status=dead }}</ref> The current reimbursement formula is known as "ASP+6" since it reimburses physicians at 106% of the ASP of drugs. Pharmaceutical company discounts and rebates are included in the calculation of ASP, and tend to reduce it. In addition, Medicare pays 80% of ASP+6, which is the equivalent of 84.8% of the actual average cost of the drug. Some patients have supplemental insurance or can afford the co-pay. Large numbers do not. This leaves the payment to physicians for most of the drugs in an "underwater" state. ASP+6 superseded Average Wholesale Price in 2005,<ref>{{Cite news|last=Pollack|first=Andrew|date=2005-07-19|title=Law Impedes Flow of Immunity in a Vial |language=en-US|work=The New York Times|url=https://www.nytimes.com/2005/07/19/health/policy/law-impedes-flow-of-immunity-in-a-vial.html|access-date=2023-01-06|issn=0362-4331}}</ref> after a 2003 front-page ''[[New York Times]]'' article drew attention to the inaccuracies of Average Wholesale Price calculations.<ref>{{Cite news |last=Pear |first=Robert |author-link=Robert Pear |date=2003-08-06 |title=Cancer Drugs Face Funds Cut In a Bush Plan |language=en-US |work=The New York Times |url=https://www.nytimes.com/2003/08/06/us/cancer-drugs-face-funds-cut-in-a-bush-plan.html |access-date=2023-01-06 |issn=0362-4331}}</ref>

This procedure is scheduled to change dramatically in 2017 under a CMS proposal that will likely be finalized in October 2016.