LH-RH analog fees plummet: Get ready now for 2005 by talking to your reps

Why This Topic Matters

It helps practices understand a major reimbursement shift that can affect drug purchasing, contracting, and billing workflows for commonly used office-administered therapies in urology.

Article Sections

1. Proposed 2005 physician fee schedule impact

   Overview of the proposed Medicare payment changes and their effect on office-administered drug reimbursement in prostate cancer care. The section frames the financial impact on urology practices and compares broader specialty effects.

2. Practice response and drug supplier contracting

   Discussion of practical responses for practices, including supplier contracting, medication sourcing options, and operational planning. The section emphasizes reimbursement management and long-term preparation.

3. Medicare Modernization Act payment methodology changes

   Explanation of the shift in how Medicare drug payment is determined under the updated payment structure. The section also places the issue in the context of affected specialties and overall fee schedule trends.

4. Charging the patient for Lupron

   Summary of a local Medicare policy discussion involving beneficiary payment considerations and the circumstances under which additional payment may be considered. It also addresses documentation and claim submission themes.

5. Billing the patient for the difference

   Coverage of modifier use, advance notice documentation, and patient liability documentation related to billing arrangements. The section focuses on administrative requirements and policy language.