Corporate Compliance

Tip: Check your 2007 reimbursement for specific drugs

Compliance Monitor, August 1, 2007

CMS acknowledged incorrect drug payments in the first and second quarters of 2007. This included seven drugs with incorrect payment rates for dates of service effective January 1-March 31 (C9350, J0152, J0215, J0289, J7342, J8560, and J9268), and two drugs with dates of service effective April-June 30 (Q2017 and J2503). You can find a complete list of these drugs' long descriptors and corrected payment rates in Tables 6 and 7 of Transmittal 1259.

Some of the payment errors were significant, and Dave Fee, MBA, marketing manager of outpatient products for 3M Health Information Systems in Salt Lake City strongly recommends that hospitals that administer these drugs review their payments for these periods. "Hospitals are responsible for going back and doing that review," he says.

To access Transmittal 1259, go to the CMS Web site at www.cms.hhs.gov/Transmittals/downloads/R1259CP.pdf.

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