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In those sections of the Medicare Claims Processing Manual, the pricing calculation for WAC and AWP respectively, is described as the lesser price of: The median of all generic forms of the drug or biological

However, because they are not yet FDA-approved for medical use, access is typically through compounding pharmacies or clinical research settings

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While prepaid shared savings will be helpful in providing successful ACOs with additional cash flow that would encourage their investment in activities that could potentially reduce ACOs' costs and improve the quality of care that ACOs provide to their beneficiaries, overpaying ACOs might result in a level of outstanding debt for some ACOs that could disrupt their operations and potentially their participation in the Shared Savings Program as well as generate unnecessary financial risk for CMS

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