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2012 Schloen, Anne

We proposed at 428.202(d)(1) the following formula to illustrate how CMS will calculate the benchmark period manufacturer price for a Part D rebatable drug with a payment amount benchmark period identified at 428.202(c)(1): (AMP for calendar quarter beginning January 2021) multiplied by (sum of monthly AMP units for January 2021 calendar quarter divided by sum of the units reported for the 3 quarters of the payment amount benchmark period) + (AMP for calendar quarter beginning April 2021) multiplied by (sum of monthly AMP units for April 2021 calendar quarter divided by sum of the units reported for the 3 quarters of the payment amount benchmark period) + (AMP for calendar quarter beginning July 2021) multiplied by (sum of monthly AMP units for July 2021 calendar quarter divided by sum of the units reported for the 3 quarters of the payment amount benchmark period) For a Part D rebatable drug with a payment amount benchmark period identified at 428.202(c)(2) through (5), we proposed the following formula at 428.202(d)(2) to illustrate how CMS will calculate the benchmark period ( manufacturer price for a Part D rebatable drug: (AMP for calendar quarter beginning January) multiplied by (sum of monthly AMP units for January calendar quarter divided by sum of the monthly units reported for the 4 quarters of the payment amount benchmark period) + (AMP for calendar quarter beginning April) multiplied by (sum of monthly AMP units for April calendar quarter divided by sum of the monthly units reported for the 4 quarters of the payment amount benchmark period) + (AMP for calendar quarter beginning July) multiplied by (sum of monthly AMP units for July calendar quarter divided by sum of the monthly units reported for the 4 quarters of the payment amount benchmark period) + (AMP for calendar quarter beginning October) multiplied by (sum of monthly AMP units for October calendar quarter divided by sum of the monthly units reported for the 4 quarters of the payment amount benchmark period) CMS received public comments in response to the comment solicitation in the CY 2025 PFS proposed rule on alternatives considered for calculating the benchmark period manufacturer price when AMP is missing (89 FR 61965-61967)

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