Delores L. Galias, RN, RHIT
STATEMENT OF CONFIDENTIALITY:
The information contained in this electronic message and any attachments to this message are intended for the exclusive use of the addressee(s) and may contain confidential or privileged information. If you are not the intended recipient, please notify D. Galias, RN, RHIT immediately at [EMAIL PROTECTED] and destroy all copies of this message and any attachments. Thank you for your cooperation
--- Begin Message ---Good Morning To All, The HHS Office of Inspector General has posted three Inspection Reports to the website. Summaries of the reports follow. Selecting the link immediately following the title will take you directly to the full document.INSPECTION REPORT SUMMARIES Medicare Reimbursement for Lupron (OEI-03-03-00250) http://oig.hhs.gov/oei/reports/oei-03-03-00250.pdf This final inspection report determines the amount Medicare would save if all carriers established a least costly alternative policy for Lupron (leuprolide acetate 7.5 milligrams (mg) depot suspension). OIG found that if carriers in 10 jurisdictions were to implement a least costly alternative policy for Lupron, Medicare and its beneficiaries would save $40 million per year. In 2003, Medicare carriers in 47 of 57 jurisdictions applied a least costly alternative policy to Lupron, reimbursing $446.49 for 7..5 mg of the drug. In comparison, carriers in the 10 jurisdictions without a least costly alternative policy reimbursed $611.56 for the same amount of Lupron. OIG recommends that CMS encourage all Medicare carriers to apply a least costly alternative policy to Lupron. __________ Update: Excessive Medicare Reimbursement for Albuterol (OEI-03-03-00510) http://oig.hhs.gov/oei/reports/oei-03-03-00510.pdf Medicare continues to pay more for albuterol than other payors, costing the program and its beneficiaries millions of dollars a year. For example, if Medicare were able to reimburse for albuterol at the Medicaid Federal Upper Limit amount, the program would have saved $263 million in calendar year 2002. Furthermore, data collected from a drug wholesaler and a group purchasing organization showed that pharmacies were able to purchase albuterol for substantially less than the Medicare reimbursement amount. Since the last OIG report on this subject, the price at which albuterol was available to the supplier community had decreased, while the Medicare reimbursement amount had remained the same. In addition, the median Federal Supply Schedule price available to the Department of Veterans Affairs in 2003 for albuterol was $0.05 per milligram (mg), compared to $0.47 per mg for Medicare. __________ Update: Excessive Medicare Reimbursement for Ipratropium Bromide (OEI-03-03-00520) http://oig.hhs.gov/oei/reports/oei-03-03-00520.pdf Medicare also continues to pay more for ipratropium bromide than other payors. If Medicare were able to reimburse for ipratropium bromide at the Medicaid Federal Upper Limit amount, the program would have saved $386 million in calendar year 2002. Data collected from a drug wholesaler and a group purchasing organization showed that pharmacies were able to purchase ipratropium bromide for substantially less than the Medicare reimbursement amount. As with albuterol, the price at which ipratropium bromide was available to the supplier community has decreased since the last OIG report on this issue, while the Medicare reimbursement amount had remained the same. In addition, the median Federal Supply Schedule price available to the Department of Veterans Affairs in 2003 for ipratropium bromide was $0.39 per milligram (mg), compared to $3.34 per mg for Medicare. ______________ Well, that's all for now. As always, if we can provide you with further information or assistance please don't hesitate to let us know either by email ([EMAIL PROTECTED]) or by phone (202/619-1343) how we can help. Hope you have a great week. -- Don White, Public Affairs ______________________________ The Office of Inspector General (OIG) of the Department of Health and Human Services (HHS) protects the integrity of HHS programs from fraud, waste and abuse through its nationwide network of auditors, investigators and analysts. In FY 2003, OIG saved taxpayers a record $23 billion, excluded 3,275 people and companies from Medicare/Medicaid reimbursement, secured 576 criminal convictions and 243 civil actions.
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