Lawmakers Question Medicare Payments For Anemia Treatment; Scheduled Medicare Fee Reduction For Power Wheelchairs Takes Effect

Main Category: Medicare / Medicaid / SCHIP
Also Included In: Blood / Hematology;  Rehabilitation / Physical Therapy
Article Date: 22 Nov 2006 - 14:00 PDT


The following summarizes recent news related to Medicare payments.

• Epoetin: House Ways and Means Committee Chair Bill Thomas (R-Calif.) and Rep. Pete Stark (D-Calif.), ranking member of the panel's Health Subcommittee, on Nov. 15 sent a letter to acting CMS Administrator Leslie Norwalk asking why Medicare pays for doses of the anemia treatment epoetin that are higher than the FDA-recommended level, CQ HealthBeat reports. The label for epoetin -- which is used to treat anemia in kidney dialysis patients -- recommends 10 to 12 grams per deciliter of blood, although Medicare will pay for up to 13 grams per deciliter of the drug (Reichard, CQ HealthBeat, 11/16). The letter says the results of a recent study in the New England Journal of Medicine show that higher doses of epoetin are not beneficial. The letter says that the Medicare policy on payments of epoetin, which was relaxed in April to allow higher doses, "is not aggressive enough to stem the systematic abuse of [epoetin], resulting in costs to taxpayers and potential health dangers to patients" (Bloomberg/Los Angeles Times, 11/17).
  
  
• Wheelchairs: The new fee schedule for Medicare payments for power wheelchairs took effect Nov. 15, the Newark Star-Ledger reports. CMS earlier this month reduced a previously proposed reduction in the payments, but some suppliers say that "they still will be hurt by the cuts," according to the Star-Ledger. CMS reduced its original proposal for cuts for standard power wheelchairs by $300, but the overall reduction will be about $2,100, according to wheelchair industry officials. Payments for some upgraded wheelchairs will decrease from about $6,000 under the old fee schedule to about $4,750 under the new rates (Stewart, Newark Star-Ledger, 11/16). Medicare officials say the reductions are necessary because of sharply increasing program expenditures for power wheelchairs. Medicare spent $1.2 billion on power wheelchairs in 2003, compared with $43 million in 1995, according to CMS (Andersen, Lincoln Journal Star, 11/16).
  

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