We are considering analyzing subgroups based on the volume of services billed by the clinicians in a group practice for a specific medical condition (for example, heart failure, joint replacement, etc.) or a specific procedure (beta blocker therapy, stent placement, hip and/knee surgery, etc.)
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We note that under the methodology proposed in section III.A.2.c, in circumstances in which some, but not all NDCs of a single or multiple source drug are negative or zero, we would similarly calculate the payment limit using only NDCs with positive manufacturer's ASP data from the given quarter and omitting those that had declined to zero or a negative value in ASP or sales
(3) Measures Proposed for Use in the APP Quality Measure Set and APP Plus Quality Measure Sets In the CY 2021 PFS final rule, we adopted the current APP quality measure set (85 FR 84860 and 84861)
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1302, 1395hh, and 1395rr(b)(l)
