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Accordingly, under section 1833(t)(14)(D)(ii) of the Act, we intend to conduct a survey, with the survey submission window opening by early CY 2026, of the acquisition costs for each separately payable drug acquired by all hospitals paid under the OPPS

One of these commenters suggested we prohibit hospitals from charging patients more than a payer-specific negotiated charge dollar amount and presume that any MRF that has payer-specific negotiated charges represented as percentages and algorithms is automatically non-compliant with our requirements

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If switching the route of administration and dosage don't help, you may also have like a substrate issue