Medicare Compliance & Reimbursement
New Research--Patients Need MTM Now
Add this study to the pile of evidence supporting a greater role for community pharmacists in medication therapy management (MTM).
New research from the National Council on Patient Information and Education suggests that millions of U.S. residents with chronic conditions either do not take medications correctly or stop taking them altogether, according to a report released in August.
The report, "Enhancing Prescription Medicine Adherence: A National Action Plan," notes that people who initially are symptom-free are particularly at risk. For example, only about half of hypertension patients follow their prescribed drug regimen, even though high blood pressure triples the risk of heart disease.
Poor adherence could be costing the nation as much as $177 billion in medical bills and lost productivity per year, and it is associated with up to 40 percent of nursing home admissions, the report finds
Stumbling block: Though there's plenty of recognition that pharmacists can help address the problem, federal policies are failing to clear the way.
"Statutorily, we still have very little guidance from the feds [about medication therapy management within Part D]," says Stacey Swartz of the National Community Pharmacists Association.
The greatest opportunities for pharmacists may lie with managed care plans, she says, since they focus on improving outcomes overall--not just controlling drug costs.
Resource: To find out more about the report or to purchase a copy ($50), go to www.talkaboutrx.org/med_compliance.jsp.
Medicare Compliance & Reimbursement
- PHYSICIANS:
You Could Lose All Your Payments For 99325 Next Year
CPT 2009 may contain new combined echocardiography code
A provision in the 2008 Physician Fee Schedule [...] - STUDIES & REPORTS:
New Research--Patients Need MTM Now
Group's call to action includes you
Add this study to the pile of evidence supporting a greater [...] - CPT 2008:
You May See Money For Substance Abuse Counseling
But will Medicare actually pay for these new codes?
Good news: If your doctor goes the [...] - CCI EDITS:
Avoid Spinal Surgery Denials By Heading CCI Changes
No modifier will overcome 13.3's hundreds of new surgery edits
Bad news: You can pretty much [...] - HOSPITALS:
Medicare Payments To Hospitals Cut By $20 Billion
Inpatient prospective payment systems changes lauded by Leapfrog
Starting Oct. 1, 2007 Medicare and Medicaid patients [...] - COMPLIANCE:
Correct Coding Initiative HIts Catheterization, Prostate Surgery Hard
Make sure your documentation justifies an extra $100 per procedure
Heads up: October's update to the [...] - PATIENT EDUCATION:
Lead The Way To Part D Subsidies
Make your mantra 'When in doubt, fill it out'
If some of your customers are among [...] - INDUSTRY NOTES:
Elderly Need Education On Immunizations, Screenings
Plus: Get ready to see less for Moh's
Medicare launched a 120-city bus tour this summer [...]
