tci Medicare Compliance & Reimbursement - 2004 Issue 21

Dialysis: OIG Says Dialysis Drug Payments Exceed Costs

Government continues to take closer look at drug costs.Last year, Medicare's four largest kidney dialysis providers paid between 12 and 68 percent below the program's reimbursement rates for 10 end-stage renal disease drugs, according to a report released May 5 by the HHS Office of Inspector General. In the report, mandated by last year's Medicare Modernization Act, the OIG found that four of the ten drugs had acquisition costs at least 50 percent below reimbursement levels. When weighted by total Medicare reimbursement for each drug, acquisition costs ran an average of 22 percent below reimbursement costs.Dialysis...

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