NEWSWIRE
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New neb-med pricing dispenses few surprises |
By Theresa Flaherty Managing Editor - 06.22.2009
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YARMOUTH, Maine – Reimbursement for nebulizer medications will stay about the same for the third quarter of 2009, giving providers a chance to catch their breath.
The latest average sales price (ASP) figures, released last week, put albuterol (J7613) at 13 cents per dose, up 1 cent from the second quarter; and ipratroprium (J7644) at 20 cents per dose, down 1 cent.
"When we can see six or nine months ahead, that's a wonderful thing," said provider Dave McDonald, president/owner of Senior Respiratory Solutions in Texarkana, Texas. "It makes our lives easier. We take the dispensing fee and provide excellent service."
One surprise: Generic DuoNeb (J7620) was up 1 cent, to 25 cents per dose.
"I anticipated that would drop," said Wayne Vega, vice president of sales for Harvard Drug Group. "But the main manufacturers of generic DuoNeb haven’t been as aggressive in the past as they are now (with pricing). Now they are getting low, low pricing out there, and we'll see the impact (on future ASP figures) possibly next quarter or the one after that."
The ASP for Brovana (J7605) and Perforomist (J7606) remained high, at $5.08 and $4.38 per dose, respectively. With the two competing long-acting drugs so close in price, some industry watchers worry about a price war and a subsequent drop in ASP.
"The flip side—if the ASP stays so high, a lot of pharmacies are reluctant to go to it,” said Chuck Makarov, president/CEO of Letco. “The co-pay on a $5 per dose drug is higher than the co-pay on a 20 cent per dose drug. If they have somebody that doesn’t pay, it doesn’t take much to lose money."
But steady ASP figures don’t necessarily mean there's a lot of profit to be made on neb-meds. The $33 dispensing fee barely covers the cost of doing business, points out provider Sam Jarczynski, president of St. Petersburg, Fla.-based RxStat.
"This is strictly a dispensing fee business," he said. "Our shipping (costs us) an additional $8 and billing and paperwork processes another $10. Then you add in the cost of the shipping box and the pharmacist's time—it's a skinny margin."
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CALENDAR
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| 3-3 Winning by Numbers: How Lean Businesses Get Their Employees to Think Like O | One of the key success factors associated with effective lean healthcare organizations is that they get their employees to think and act like owners - learn how they do it in this timely and highly relevant live webinar with Chris Calderone. This innovative webinar-based learning opportunity is specifically geared towards the unique challenges facing today's HME providers.
FMI: http://www.chriscalderone.com/feb3.html
| | 10 HITECH Act: Health Information Technology, Privacy and Security | The HITECH Act takes effect Feb 17th, 2010. The HITECH act expands HIPAA privacy and security obligations increases compliance obligations and strengthens enforcement penalties. Sweeping changes will affect every business that is involved in or works for Healthcare Organizations. This 90 minute Webinar will give you an understanding of HIPAA and HITECH, risks and key requirements of these laws, the impact on business associates and the covered entity.
One hour of your time today could save you thousands tomorrow.
1:00 PM - 2:30 PM EST
Space is limited.
Reserve your Webinar seat now at:
https://www2.gotomeeting.com/register/207314795
| | 11-11 Southern California Rally for HR 3790 | AMEPA and CAMPS are hosting a rally to support HR 3790, the bill to repeal competitive bidding. The bill needs 219 co-sponsors. Southern California is home to 25 of California's 53 Congressmen. Local representatives, the media and patients will be invited to attend.
Holiday Inn and Conference Center, Buena Park (just outside Anaheim)
10 a.m. to 12 p.m. RSVP to info@amepa.us
| | 16-16 DME Billing 101: Patient Intake and Assessment | 2:00pm - 3:00pm EST
Join Andrea Stark for this first in a special three-part billing series, where you’ll learn how to reduce rejections and denials by knowing:
What needs to be included in patient charts to ensure compliance with Medicare rules and policies.
What questions to ask before agreeing to take on a patient.
Basic documentation and signature requirements for general DME, including when CMNs, DIFs and WOPDs should be used.
How to determine if and when you will need to utilize an ABN, obtain a renewal ABN, and ensure that they are compliant.
This webinar will help reduce your chances of failing an audit by teaching you what to look for before submitting a claim.
| | 23-26 MESA All-Star Conference 2010 | February 23-26 (dates include optional, stand-alone Billing Boot Camp on 23rd; there is also an optional driver/delivery tech certification program on 26th, concurrent with general sessions)
Includes general sessions on legislative updates; HR law; consignment closet rules; staying accredited and changing accreditors; alternative revenue sources; patients traveling with oxygen; evaluating, selling and buying an HME; and a panel with CMS, CIGNA, the RAC and CBIC.
The St. Anthony Hotel, San Antonio, TX
Conference Index Page:
http://www.mesanet.org/index.php?src=gendocs&ref=10conference_index&category=MESA_conference
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| 1-3 AAHomecare Washington Legislative Conference | The American Association for Homecare will host the Washington Legislative Conference, March 1-3, 2010 ,at the Capital Hilton, Washington, D.C.
It is impossible to have a strong impact on home medical equipment policy without more involvement on Capitol Hill. In 2010, the home medical equipment community faces continued challenges: competitive bidding, complex mobility policy, the oxygen cap, and other regulatory and legislative concerns.
So we are asking HME stakeholders to make their voice heard. AAHomecare will provide background materials for this key annual lobbying event for the HME sector. Speakers during the conference will include members of Congress and officials from CMS.
For more information, please visit www.aahomecare.org
| | 2-3 CAMPS Annual Convention | Attend the CAMPS Convention for only $125 (member pricing) and attend as many of the various sessions. The schedule is divided into tracks to help you determine the best sessions for your interest. This year's line-up includes sessions such as: Business Management, Operations / Reimbursement, Exemptee Training, Respiratory CE*, RESNA RT Prep Test. Earn 6 units of continuing education with the American Association for Respiratory Care (AARC). Do not hesitate, register by February 1, 2010 to take advantage of the $50 savings. Register here: http://member.campsone.org/cgi-shl/TWServer.exe?EREG:OrderEvent:2010AM
| | 18-18 DME Billing 102: AR Management Strategies | 2:00pm - 3:00pm EST
Join Andrea Stark for the second installation in a special three-part billing series, where you’ll learn how to:
Prescreen your claims for potential denials.
Utilize technology to submit claims electronically, reduce the burden on your AR department, and decrease your risk of getting denied.
dentify potential same or similar, medical necessity, or other eligibility issues (i.e. SNF stays).
Establish an AR Strategy and ensure that reporting tools effectively capture the vulnerabilities of claim processing to include analysis of claim rejections, days sales outstanding and denials.
This webinar will provide you with the tips and tools you need to be sure you are properly submitting claims to Medicare, the first time around.
| | 18-18 Florida Home Care Conference | AMEPA and FAHCS present the third annual Florida Home Care Conference. Scheduled to appear: Walt Gorski (Washington update), Jeff Baird (Legal), Mark Higley (Audits), Sean Schwinghammer (Tallahassee update), Sylvia Toscano (Billing) and Ty Bello (Referrals).
FMI: visit www.amepa.us or e-mail info@amepa.us
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| 19-21 Essentially Women Focus on the Future 2010 Tradeshow & Conference | Annual event features manufacturer exhibits, networking and educational sessions for womens health providers. Louisville, Ky.
FMI: call 800-988-4484, visit www.essentiallywomen.com or email melissa@essentiallywomen.com
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