tci Medicare Compliance & Reimbursement - 2003 Issue 32

CMS SEEKS COMMENT ON FOUR PAYMENT SCHEMES

According to the Centers for Medicare & Medicaid Services, increasing practice expense reimbursements is irrevocably linked to decreasing drug payments, since the agency only has authority to do the former by using funds gained from the doing the latter. Under the first alternative offered in the rule, drug reimbursements by Medicare contractors would be limited to the amounts the contractors pay private policyholders in "comparable" circumstances. CMS says implementing this option would save the government $4.1 billion, and beneficiaries $2.6 billion, over 10 years. CMS' second option, similar to the Senate approach, would set payment for each...

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