CMS Will Drop Inhalation Therapy Dispensing Fee to $33 per Month, USA

Main Category: Caregivers / Homecare
Article Date: 06 Nov 2005 - 3:00 PDT

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This evening, the Centers for Medicare and Medicaid Services (CMS) announced a dramatic drop in the monthly dispensing fee for inhalation drug therapy from the current $57 per monthly supply to $33 in 2006. In the every first month, when the fee would be $57, then drop to $33 for succeeding months. The 90-day supply would be reduced from the current $80 to $66 in 2006. The figures are included in the 2006 physician fee schedule.

AAHomecare has demonstrated repeatedly that even at $57 per month, the dispensing fee does not cover the many services associated with providing home inhalation drug therapy to Medicare beneficiaries and that there is no data that justifies a reduction in the fee.

A statement from CMS states, "On further review of the available information and comments, CMS has concluded that the industry cost data on which the 2005 dispensing fee was based includes care management activities (such as in-home visits, patient education, caregiver training, and care coordination) that do not fall within the scope of a dispensing fee, and that do not have a Medicare benefit category…. Therefore, for 2006, CMS is establishing a dispensing fee of $57 for a 30-day prescription for the first time a Medicare beneficiary uses inhalation drugs and a $33 fee for other months."

American Association for Homecare
625 Slaters Lane, Suite 200
Alexandria
VA 2314
USA
For more information, please call AAHomecare at (703) 836-6263.
http://www.aahomecare.org.

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