Washington

Industry lobbying may be paying off as legislators take note of MMA's shortcomings — including its mandate of an ASP (average sales price) plus-6-percent reimbursement for inhalation drugs scheduled for 2005. The system could severely affect providers' margins and, according to observers, could drive some HMEs out of business altogether.

As a result, AAHomecare reported in June that Sen. Arlen Specter, R-Pa., sent a letter to CMS Administrator Mark McClellan explaining how the measure would hurt beneficiary access. Specter chairs the Senate Appropriations Subcommittee on Labor, Health and Human Services.

“This pricing does not take into account the significant administrative costs associated with delivery of these home care therapies,” the senator wrote. “I therefore urge you, as you develop rulemaking, to use your discretionary authority to include an appropriate dispensing fee to cover significant administrative expenses such as the costs of getting the drugs to beneficiaries.”

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