Medicare Compliance & Reimbursement

But don't get used to the new money just yet. The Centers for Medicare & Medicaid Services added five new medications and one new technology to the pass-through payment list, effective July 1 -- but because CMS doesn't have enough cost information yet, the current reimbursement amount could change. Four of the five new drugs are injectable therapies for cancer patients: Pemetrexed, Bevacizumab, Cetuximab, and Abarelix, some of which hopefully come with a nickname. You'll also score pass-through payment for Omalizumab, an injectable medication for allergy-induced asthma. If providers administered any of these drugs before the July 1 implementation of pass-through, they can still earn a decent payback: submit adjustment bills, and they'll receive 95 percent of the medication's average wholesale price (AWP). Check out the CMS program transmittals R194CPand R195CP, available online at www.cms.hhs.gov/manuals.