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CMS-1403-FC
add-on percentage of 15.5 percent. As such, the drug
add-on adjustment to the composite rate for CY 2009 would
be equal to 1.155 * 0.996 = 1.15 or 15.0 percent.
We solicited public comment on our proposal of a zero
update, as well as the alternative approach presented
above, so that we could make an informed decision with
respect to the final update to the CY 2009 drug add-on
adjustment to the composite rate.
Comment: Commenters were uniformly opposed to any
decrease in the drug add-on adjustment, citing the plain
reading of the statute which calls for an annual “increase”
in the adjustment. As support for the reliance on the
plain reading of the statute, several commenters cited case
law examples in which courts have relied on dictionary
definitions, biblical text, and common usage of terms for
purposes of interpreting statutory text. One commenter
disagreed with CMS’ alternative reading of 1881(b)(12)(F)
of the Act, under which an increase in the drug add-on
could not be implemented when estimated drug growth is
negative, pointing to MMA Conference Report language that
referenced a payment update that would be based on a
“growth” in drug spending and “drug cost increases.”
Commenters further argued, citing case law the priority on
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