Tag: Nebulizer
OIG: Lincare mostly complied with neb-med policies
December 21, 2017HME News Staff
CLEARWATER, Fla. - Lincare Pharmacy Services generally complied with Medicare requirements when billing for inhalation drugs, according to a new report from the Office of Inspector General. Of 100 claim lines sampled, three did not comply because the beneficiaries medical records did not support medical necessity, resulting in $48 in overpayments. The OIG recommends that Lincare ensure that medical necessity is adequately supported in medical records before billing Medicare. Lincare concurred.
DirectRx wins bid contract for nebulizers
October 25, 2016HME News Staff
TROY, Mich. - DirectRx Pharmacy, an independent pharmacy, says it has won a competitive bidding contract for nebulizers and related supplies as part of Round 1 2017. Under the contract, which runs from Jan. 1, 2017, through Dec. 31, 2018, DirectRx will supply nebulizers and supplies to Medicare beneficiaries in Kansas City, and in Dearborn, Franklin, Ohio and Union counties in Indiana. “DirectRx is proud to be awarded this contract so that we can further our vision of helping patients with...
In brief: Gov't delays hearings, Cardinal highlights AssuraMed
November 1, 2013HME News Staff
WASHINGTON - The Office of Medicare Hearings and Appeals (OMHA) will defer assignments for hearings—possibly up to 28 months, according to a recent notice. Requests for hearings received after July 15, 2013, will be entered into the agency's case processing system and held until there is room on an Administrative Law Judge's (ALJ) docket for adjudication. When a request is assigned, a notice will be sent, according to the notice. The ALJs have been backlogged for more than a year,...
ASP: Winners, losers, audits
October 25, 2013Theresa Flaherty, Managing Editor
BALTIMORE - With few exceptions, the average sales price (ASP) figures for nebulizer medications don't change much from quarter to quarter. That doesn't mean the market is stagnant, says Wayne Vega, senior vice president of the Inhalation Drug Group. He recently offered HME News his take on the fourth quarter numbers—and the market.
Winners
Budesonide (J7626) increased 85 cents, to $5.95 per dose. The entry of another generic version of the drug into the market earlier this year...
In brief: Seven more sign on, ResMed takes new action
July 26, 2013HME News Staff
WASHINGTON - In the wake of the industry's recent virtual fly-in, H.R. 1717 has picked up an additional seven co-sponsors, bringing the current total to 144. The bill, which was introduced April 24 by Rep. Tom Price, R-Ga., would repeal the competitive bidding program and replace it with a market-pricing program (MPP). “Shoring up that support is important,” said Cara Bachenheimer, senior vice president of government relations for Invacare. “Feeding lawmakers information about the...
NSG to review nebulizers
July 24, 2013HME News Staff
WASHINGTON - National Government Services (NSG), the Jurisdiction B DME MAC, will initiate a widespread prepayment review of nebulizers (E0570), related drugs, accessories and dispensing fees, it announced in a recent message. Providers that receive an additional documentation request should provide, within 45 days, the following: a copy of a signed and dated detailed written order; a copy of the dispensing order, if applicable; a copy of medical records supporting medical necessity; and proof of...
IDG offers Ritedose of help
May 7, 2013Liz Beaulieu, Editor
SOMERVILLE, N.J. - It's not easy being a smaller provider of nebulizer medications in the world of “Big Pharma.”
That's why Inhalation Drug Group (IDG), a group purchasing organization, has rolled out a program targeting these smaller providers, giving them access to volume discount pricing, extended terms and sampling programs.
“We're reaching out to the smaller end, because they're almost the more important players,” said Wayne Vega, senior executive...
In brief: Few changes in new ASP figures
October 24, 2012HME News Staff
BALTIMORE - The new average sales price (ASP) figures for nebulizer medications released in September brought few changes. Albuterol (J7613) was down 2 cents to 13 cents per dose, while budesonide (J7626) was down nearly 11 cents to about $4.87 per dose. Levalbuterol (J7614) and ipratropium (J7644) stayed flat at 65 cents and just under 13 cents per dose, respectively. Brovana (J7605) was down almost 14 cents per dose to $5.22, and Perforomist (J7606) was up just more than 12 cents per dose to $5.21.
ADW...
In brief: Audit oversight, ABN guidance, 10,000 letters
June 15, 2012HME News Staff
WASHINGTON - Members of the House Energy and Commerce Oversight Subcommittee cast serious doubt on CMS's ability to manage its audit contractors at a hearing June 7. As proof, Chairman Rep. Cliff Stearns, R-Fla., pointed out that CMS sent the subcommittee incorrect ZPIC performance data, according to AAHomecare officials, who attended the hearing. Stearns said the error “confirms CMS's utter incompetence in conducting any meaningful oversight of these contractors.” Other members...
Budesonide: Competing generics on the horizon
January 22, 2012Theresa Flaherty, Managing Editor
BALTIMORE - The needle barely moved on the average sales price (ASP) figures for nebulizer medications, according to the latest figures, released in December. The only neb-med to show any significant change was budesonide (J7626), which rose 23.8 cents to $4.63 per dose.
While an increase is always welcome, there's still not a lot of margin on the drug, says provider Sam Jarzcynski, who stocked up in advance of an October price increase.
"We were able to buy enough to get us through,"...