Magazine article Drug Topics

NARD Continues Medicare Part B Battle with HCFA

Magazine article Drug Topics

NARD Continues Medicare Part B Battle with HCFA

Article excerpt

It's an uphill battle, but NARD is fighting hard to change policies enacted under the Health Care Financing Administration's regional carrier system for handling Medicare Part B durable medical equipment claims.

NARD is especially concerned about a proposed HCFA policy that would require Medicare beneficiaries to use a metered-dose inhaler (MDI), a non-covered item, before being prescribed a nebulizer, a covered item, said Tim Redmon, director of NARD's home healthcare regulatory affairs and long-term care pharmacy services.

In the summer of 1994, HCFA set up a program whereby Medicare Part B claims would be handled by four regional carriers, rather than the previous 34. At the same time, the federal agency reviewed the policies for all the items covered under Medicare Part B. NARD, as well as other health-care groups, stormed HCFA with comments about some of the proposed policies.

Since then, HCFA has stopped issuing cash advances to pharmacies, except in isolated instances, Redmon said. Initially, turnaround time on claims was so slow that HCFA was providing lump sums to pharmacies having cash flow problems.

Also on a positive note, HCFA is in the process of revising its certificates of medical necessity so that they will be more "physician-friendly," Redmon said. …

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