tci Medicare Compliance & Reimbursement - 2005 Issue 2

PHYSICIANS: Least Costly Alternative' Could Cost Docs A Bundle

And 'pool leakage' soaks surgeons for $60 million. Some carriers are going haywire with overzealous implementation of an obscure Medicare requirement to pay only for the cheapest drugs.Medicare requires carriers to pay for the "least costly alternative" for drugs. This doesn't mean doctors have to provide the cheapest drug for a particular condition, but it does mean that if you provide a more expensive drug, the carriers will only pay you for the cheaper alternative.Some carriers are applying this rule in instances where it makes no sense, providers complained to the Practicing Physicians Advisory Council's Nov. 22...

To read the full article, sign in and subscribe to tci Medicare Compliance & Reimbursement.


Keep pace with evolving Medicare regulations — and onboard your team — with timely analysis of critical updates interpreted in an easy-to-follow, easy-to-apply format. Your subscription to TCI's Medicare Compliance & Reimbursement Alert will equip you to navigate code and guideline changes, CCI edits, and revisions to modifiers, payer policies, the fee schedule, OIG target areas, and more.

  • Current newsletters added each month
  • Fully searchable archives - over 4200 articles
  • ALL years/issues back to 2003 organized by year and issue
  • Codes mentioned in articles are linked to Code Information pages
  • Code Information pages link back to related articles
Access to this feature is available in the following products:
  • tci Medicare Compliance & Reimbursement +Archives

demo
request yours today
subscribe
start today
newsletter
free subscription

Thank you for choosing Find-A-Code, please Sign In to remove ads.