tci Medicare Compliance & Reimbursement - 2006 Issue 15

PART D: CMS Mulling Pharmacist Payment Adjustments To Shore Up Drug Benefit

Industry consolidation may narrow Medicare drug benefit to fewer plans next year.News reports have highlighted some pharmacists' financial problems stemming from the Medicare prescription drug benefit, purportedly relating to health plans' slower reimbursement for dual eligibles' claims. (See related story in this issue.) Now the Centers for Medicare & Medicaid Services is considering increasing reimbursements for pharmacists who convince customers to switch from brand-name to generic medications, according to CMS Administrator Mark McClellan.Another proposal CMS is deliberating is to make substantial billing and coding changes that would reduce costs for filing medical claims, says CMS spokesman...

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