tci Medicare Compliance & Reimbursement - 2005 Issue 13

PHYSICIANS: Count On Local Carriers For Least Costly Policy Fixes

PPAC: CMS to remove drugs from update formula retroactively.Least costly alternative policies create an "unlevel playing field" across the country because some Part B carriers don't apply them, or apply them differently than others, physicians complain. And in the wake of steep cuts to drug payments, these policies make it even harder for physicians to provide badly needed drugs.Currently, individual carriers can decide whether or how to implement LCA policies, which will only pay the price of the cheapest alternative to a particular drug, officials from the Centers for Medicare and Medicaid Services told the Practicing Physicians'...

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