tci Medicare Compliance & Reimbursement - 2005 Issue 35
Physicians: Docs Don't Want Drug Bidders Dragging Prices Down
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Article Overview
This article summarizes a Practicing Physicians Advisory Council discussion of Medicare payment policy changes affecting Part B drugs and physician practice expense calculations. It is relevant to physicians, medical practice administrators, and coding/reimbursement professionals who follow CMS payment methodology, the physician fee schedule, and the Competitive Acquisition Program. The article covers advisory recommendations to CMS, concerns about administrative burden, and calls to delay implementation of a new practice expense RVU formula.
Why This Topic Matters
The topic affects how physician practices are paid for Part B drugs and how practice expense values are determined under the physician fee schedule. Readers tracking Medicare reimbursement policy will want to understand the issues raised by PPAC and the CMS proposals discussed in the article.
What You Will Learn
- How physician advisory concerns relate to the Medicare Competitive Acquisition Program for Part B drugs
- What types of payment methodology issues were raised in connection with average sales price calculations
- Why practice expense relative value unit methodology changes drew attention from physician stakeholders
- What kinds of administrative and implementation concerns were discussed with CMS
Who Should Read This
- Physicians
- Medical practice administrators
- Coding and billing professionals
- Reimbursement analysts
- Healthcare consultants
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