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We discuss and seek comment on the circumstances in which we would exercise our discretion to reopen a payment determination and issue a revised initial determination to account for the impact of identified improper payments on Shared Savings Program calculations (as described in section III.G.7.c.(2).(b) of this proposed rule)

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Additionally, as CMS suggested in section 50 of the revised Medicare Part D Drug Inflation Rebate Guidance, CMS considered multiple options for establishing a standardized method and process to occur at regular intervals to determine an appropriate adjustment to the rebate amount for a Part D rebatable drug for an applicable period to account for revised information prior to adopting the proposal described here with two proposed regular reconciliations of the Part D inflation rebate amount

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