tci Part B Insider - 2004 Issue 43

Meetings: 'Least Costly Alternative' Could Cost You A Bundle Next Year

And 'pool leakage' soaks surgeons for $60 millionSome 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 meeting...

To read the full article, sign in and subscribe to tci Part B Insider.


Keep pace with evolving Medicare regulations with timely analysis of critical updates interpreted in an easy-to-follow, easy-to-apply format. Your subscription to TCI’s Part B Insider will equip you to navigate code and guideline changes, CCI edits, and revisions to modifiers, the fee schedule, OIG target areas, and more.

  • Current newsletters added each month
  • Fully searchable archives - over 4800 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

This feature is currently unavailable for online purchase. For more information, please call 801-770-4203 or Contact Us.

demo
request yours today
 subscribe
start today
 newsletter
free subscription

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