AAH gathers data to combat neb-med cut

Sunday, August 21, 2005

WASHINGTON -- A consultant for AAHomecare has begun circulating a survey to association members and non-members with the aim of gathering data that supports the industry's argument that CMS should not reduce the respiratory med dispensing fee in 2006.

"It is critically important that we protect the dispensing fee and that everyone who receives a survey respond as quickly as possible," said AAHomecare CEO Kay Cox.

The surveys are due Sept. 6.

CMS announced Aug. 1 that the 2006 dispensing fee "will likely be lower than the 2005 level" of $57 a month per patient. The announcement came as part of Medicare's proposed Physician Fee Schedule for 2006. The proposal comes with a 60-day public comment period.

In 2004, AAHomecare hired Muse & Associates to study the costs involved in providing inhalation drug therapy to Medicare beneficiaries. The study, the largest of its kind, concluded that if Medicare paid a dispensing fee less than $68.10 a month providers would lose money supplying two key drug therapies.

The new Muse survey will update the 2004 data and address specific questions CMS posed in August when it announced a likely reduction in the dispensing fee for 2006.

CMS wants to know the following: what services inhalation therapy suppliers provide beneficiaries; the extent to which suppliers have shifted their shipping to ground services and away form more expensive carriers like UPS; what efforts providers make to measure outcomes; and additional information on the typical dispensing costs for an efficient, high-quality supplier.

Rather than reducing the dispensing fee, providers say, the fee should be increased to reflect the escalating costs of doing business, such as fuel, labor and delivery costs. Additionally, CMS lacks the clinical data -- the impact it may have to beneficiary care and access - to support a cut in the dispensing fee, says AAHomecare.

"We are alarmed that on the heels of a staggering 89% reduction in drug reimbursement in 2005, and in the absence of any new cost data or analysis, CMS is planning further reductions to the reimbursement for nebulized inhalation medications in 2006," said Peter Kelly, CEO of Pacific Pulmonary Services (PPS). "At minimum, we were anticipating a modest increase in reimbursement to offset for inflation, similar to what CMS recommended for providers of hospice care, acute care hospitals, inpatient rehabilitation facilities and skilled nursing facilities."