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Without a reconciliation process, the Part B rebate amount will include units of discarded drugs on which manufacturers potentially owe a refund, thereby potentially requiring manufacturers to pay both a discarded drug refund and a ( rebate amount on certain units of a Part B rebatable drug due to the timing of revisions to discarded drug units discussed in further detail in section II.I.2.d.iv

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The proposed methodology modifies the assignment of those achievement points such that MIPS eligible clinicians performing near the median for a cost measure would be more likely to receive a neutral score consistent with the performance threshold than a negative score, which they would be more likely to receive under the current scoring methodology

No case reports have documented this, but the absence of evidence is not evidence of absence