OIG begins survey of inhalation drug services

Sunday, May 15, 2005

WASHINGTON -- The Office of Inspector General (OIG) last week distributed a survey to a random sample of respiratory therapy providers to gather information on the services provided to Medicare's respiratory patients in 2003.

The information the OIG is soliciting could be used to make future decisions about the dispensing fee for inhalation therapy. The fee, established under 2005's new average sales price reimbursement formula, is currently $57 for a 30-day supply and $80 for a 90-day supply of respiratory medications.

AAHomecare called the survey "critically important" and urged providers to answer the questionnaire accurately by recording all services provided and all contact made with patients. These encounters, said AAHomecare, will lend weight to the arguments that there are extensive costs associated with dispensing inhalation drugs.

AAHomecare also cautioned that the questionnaire does not cover all the possible dispensing fee service categories, including after-hours service. It also omits billing activities, which factor significantly into the cost of providing respiratory medications. These activities, said AAHomecare, should fall under the "Other" category.

The deadline to complete the survey is May 18, 2005, but respondents can request a deadline extension until June 20.

Last year, AAHomecare commissioned a study by Muse and Associates that evaluated the services of 109 pharmacies. It found that the ASP reimbursement formula would under reimburse the actual cost of providing respiratory medications. That study concluded that a $68 dispensing fee would be required to cover all the expenses.