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(5) Notwithstanding paragraph (e)(4) of this section, for a Part B rebatable drug that is a selected drug (as defined in section 1192(c) of the Act) with respect to a price applicability period (as defined in section 1191(b)(2) of the Act), in the case such Part B rebatable drug is no longer considered to be a selected drug, the benchmark period CPI-U is the CPI-U for the July of the year preceding the last year during such price applicability period

(B) Payment amount in the payment amount benchmark quarter, as specified in 427.302(d) if any inputs are restated within the reconciliation run-out period

CMS will not apply multiple rebate reductions for the same Part B rebatable drug and applicable calendar quarter

therefore, the care plan document should be updated at regularly defined intervals by the care team and patient