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In such instances, CMS proposes to calculate the average total allowed charges per individual per year for the drug using allowed charges and the number of individuals who used the drug or biological product based on claims for the previously grouped billing and payment code during the year

We stated that Medicare would pay for IOP services provided by OTPs if each service is medically reasonable and necessary and not duplicative of any service paid for under any bundled payments billed for an episode of care in a given week, and other applicable requirements are met

N Engl J Med

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The controversy around Zyn recently spilled over into politics, pitting Democrats and Republicans in Washington against each other and spiraling into another skirmish in the nation's culture war