tci Medicare Compliance & Reimbursement - 2006 Issue 25

Reimbursement: Suppliers In Holding Pattern Over Nebulizer LCD

Draft policy could reduce payment for one drug by 95 percent Whopping Medicare payment cuts may be looming for two top nebulizer-delivered drugs -- a reality that has DME suppliers calling on Congress for help. Background: In March, the durable medical equipment (DME) Program Safeguard Contractors (PSCs) -- charged by the Centers for Medicare & Medicaid Services (CMS) with promoting "the integrity" of the Medicare program as it relates to DME -- released draft local coverage determinations (LCDs) focusing on Medicare payment for nebulizers and associated medications. Coordinating their efforts, the three DME PSCs issued nearly identical...

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