{"id":966,"date":"2012-05-08T10:10:31","date_gmt":"2012-05-08T17:10:31","guid":{"rendered":"https:\/\/hartleymedical.com\/blog\/?p=966"},"modified":"2015-06-23T21:37:08","modified_gmt":"2015-06-24T04:37:08","slug":"a-cms-billing-update","status":"publish","type":"post","link":"https:\/\/hartleymedical.com\/a-cms-billing-update\/","title":{"rendered":"A CMS Billing Update"},"content":{"rendered":"

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*** UPDATE ***<\/strong><\/p>\n

I recently spoke with an individual from the International Academy of Pain Management regarding the previously discussed CMS Medicare billing issue. From this discussion, it has been suggested that CMS acknowledges that pharmacies billing Medicare for implanted drug pump medication provided “incident to”\u009d a physician service is “questionable”\u009d practice. It was also suggested that this issue will most likely come to a head in the coming months.<\/p>\n

One compounding pharmacy in particular who submits billing has admitted to this IACP source that their organization is aggressively trying to grow business in an attempt to gain market share before governmental agencies possibly ban this act “\u201c which is rumored to be happening in the next six months or so.<\/p>\n

Please be clear that Hartley Medical is not stating that what these pharmacies are doing is illegal “\u201c but we are stating that their actions are questionable<\/span><\/em>. We also cannot be 100 percent certain whether or not governmental agencies will choose to allow Medicare billing on behalf of the patient to be legal, but our research points to “not.”\u009d<\/p>\n

Here is what Hartley Medical asks of you: Please do not switch some or all of your pump practice from your current provider to one that submits billing to Medicare.<\/span><\/strong> If this is something that you have been contemplating, consider delaying your decision-making process. It appears that CMS will be announcing its decision regarding this matter in July or August, and enacting it by October. We recommend that you postpone your decision until CMS has\u00a0 reached a definitive judgment on the legalities of this issue. Do not let these companies entice you to switch in their efforts to grow their own market share by capitalizing on questionable practices that could soon be banned.<\/p>\n

I also must throw out these questions:<\/p>\n