decisionhealth Newsletters, Part B News - 2001 Issue 5 (May)
Campaign continues for cuts of average wholesale prices for drugs
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Article Overview
This article covers a policy debate around Medicare payment for drugs administered in physicians’ offices, including criticism of the current reimbursement approach, concerns from oncology groups, and testimony from former HCFA leaders. It also addresses broader Medicare administrative issues such as program management funding, proposed fees on certain paper claims, and discussion of updating the resource-based relative value scale. The piece is relevant to physicians, oncology practices, Medicare billers, compliance staff, and policy readers following federal reimbursement changes.
Why This Topic Matters
The article explains federal payment policy issues that can affect practice revenue, overhead coverage, and participation in Medicare. It also highlights related administrative and claims-processing proposals that may influence how providers are paid and how the program is managed.
Article Sections
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Medicare drug reimbursement debate
Discusses the policy dispute over how Medicare pays for drugs administered in physicians’ offices and the broader concerns raised in testimony before Congress.
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HCFA Reform
Covers testimony on agency program management funding and suggestions for administrative changes affecting Medicare oversight.
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User fees
Summarizes discussion of a proposed fee related to certain paper Medicare claims and reactions from congressional leaders.
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RBRVS
Addresses testimony calling for review and updating of the physician payment valuation system.
What You Will Learn
- The major Medicare reimbursement issues discussed in the article
- How Congress and former HCFA officials viewed agency funding and program administration
- What policy concerns were raised about claims-processing fees
- Why the physician payment valuation system was discussed in connection with reimbursement reform
Who Should Read This
- Physicians
- Medical practice administrators
- Medical coders and billers
- Oncology practices
- Medicare policy analysts
- Compliance staff
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