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To calculate the reduced total rebate amount for a Part D rebatable drug, in 428.301(b)(1), CMS proposes the following formula: Reduced Total Rebate Amount = the total rebate amount multiplied by (1 minus applicable percent reduction) multiplied by (percentage of time drug was currently in shortage during the applicable period) added to the total rebate amount multiplied by (1 minus percentage of time drug was currently in shortage during the applicable period) For the purpose of this formula, for a Part D rebatable drug that is a generic drug or a plasma-derived product, in 428.301(b)(2)(i), CMS proposes an applicable percent reduction of 75 percent for the first applicable period such Part D rebatable drug is currently in shortage, 50 percent for the second applicable period, and 25 percent for each subsequent applicable period
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We refer readers to 414.1380(b)(2) for our policies regarding scoring for the cost performance category and to previous rules where these policies were finalized, including the CY 2017 Quality Payment Program final rule (81 FR 77308 through 77311), the CY 2018 Quality Payment Program final rule (82 FR 53748 through 53752), the CY 2019 PFS final rule (83 FR 59856), the CY 2021 PFS final rule (85 FR 84877 through 84880), the CY 2022 PFS final rule (86 FR 65507 through 65509), the CY 2023 PFS final rule (87 FR 70091 through 70093), and the CY 2024 PFS final rule (88 FR 79369 through 79373)
Press, 1994)
