Medicare coughing up excessive neb payments

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04/27/2009

Once again, South Florida is in the hot seat when it comes to excessive Medicare spending. This time, it's respiratory medication.

An OIG report released last week found that while only 2% of beneficiaries live in the area, they account for 17% of Medicare spending on respiratory meds in 2007. In Miami-Dade County alone, Medicare paid almost $143 million.

The average spent per beneficiary in South Florida: $4,400 compared to $815 in the rest of the country.
Theresa Flaherty

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Comments

Move the nebuzlier medications from Medicare Part B to Medicare Part D where they belong and this issue goes away. Then you have the State Pharmacy Boards overseeing this better and the insurance carriers in the Medicare D program combatting the issue.

I agree with Bob Miller. While the Nebulizer itself is covered in Part B the Medications are in fact drugs and should be moved to part D. But this underlines an even greater issue of out dated categories within Medicare's coverage lists, secondly we need a further push into a much more modernized uniformed regulatory system that is automated with oversight from a central location. Today we as providers and beneficiaries of the current Medicare/Medicaid system we spend way to much money and man-power in oversight and regulation and errors such as the above reported still happen rather regularly. The size of the "contracted" oversight is over several billion a year, and the amount of payments paid to rouge and illegal operators is estimated over several billion dollars a year as well. MR's are necessary to prevent fraud and abuse, however we need a better more efficient system that is more automated and requires less "contractors" to operate. Combined we could save billions every year. Try Bright tree systems as an example.