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Questionable Billing for Compounded Topical Drugs in Part D

Part D spending for compounded topical drugs grew by more than 3,400 percent between 2006 and 2015, reaching $224 million. This growth in spending, combined with an increase in the number of OIG investigative cases involving compounded drugs, suggests the emergence of a fraud risk. This review will describe billing trends for topical compounded drugs under Part D. It will explore what is driving these trends, including any potential increases in prices. It will also identify pharmacies with questionable Part D billing for these drugs and any associated prescribers.

Announced or Revised Agency Title Component Report Number(s) Expected Issue Date (FY)
Completed Centers for Medicare & Medicaid Services Questionable Billing for Compounded Topical Drugs in Part D Office of Evaluation and Inspections OEI-02-16-00440 2018

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