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CMS, at its sole discretion, may determine that the billing of one or more specified HCPCS or CPT codes represents significant, anomalous, and highly suspect billing activity for a calendar year that warrants adjustment to calculations made under this part

Lastly, we are proposing to codify two scenarios when the manufacturer reports negative or zero manufacturer's ASP for all NDCs for a biosimilar for a given quarter: When positive manufacturer's ASP data is available for another biosimilar(s) with the same reference product for the given quarter, we are proposing to set the payment limit equal to the sum of the volume-weighted average of the positive manufacturer's ASP data from all other biosimilars with the same reference product plus 6 percent (or 8 percent for a qualifying biosimilar biological) of the amount determined under section 1847A(b)(4) of the Act for the reference biological product for the given quarter

The 30-day notice appeared in the Federal Register on June 3, 2024 (89 FR 47563)

It raises immediate red flags if a current employee is trying to postpone having to take a test

We'll make things a bit easier with two easy ways to stop hiccups: Take a deep breath