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Starting next year, pharmaceutical companies will have to repay Medicare for any unused amount of drugs that come in single-dose vials.

The mandate was tucked inside the bipartisan infrastructure bill passed last year, and on Thursday Medicare implemented this new provision as part of its broader annual rule that updates physician payments for 2023.

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The refund rule only applies to injectable and infused drugs that are administered by physicians in outpatient clinics, not pills obtained at pharmacies or mailed to people’s homes. Radiopharmaceuticals, certain drugs that require filtration, and newer infused drugs are excluded.

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