AAH Survey Shows Providers Not Happy with Talk of Dispensing Fee Cut

ALEXANDRIA, Va.–Nearly half of home care pharmacies will stop
providing inhalation drug therapy for seniors if the Medicare
dispensing fee is cut significantly, according to a survey
commissioned by the American Association for Homecare.

Out of 82 home care pharmacies surveyed, 44 percent said they
would stop providing the drugs if there is a substantial cut to the
fee, currently set at $57 for a 30-day supply. Another 50 percent
said they would curtail services to Medicare beneficiaries; 3
percent said they would ask beneficiaries to pay for services; and
3 percent said they would go out of business altogether as a result
of a substantial cut.

The pharmacies provide inhalation drugs to more than half of all
Medicare beneficiaries who use the therapy, according to
AAHomecare.

After CMS said in August that its 2006 dispensing fee would
likely be lowered, the association commissioned Muse and
Associates, a Washington-based research firm, to conduct the survey
during August and September.

Survey participants reported that their actual dispensing costs
for providing the inhalation drugs are higher than CMS’ current
fee, totaling $66.55 for a 30-day supply and $138.80 for a 90-day
supply.

Last week, a report from the HHS Office of Inspector General,
called “Review of Services Provided by Inhalation Drug Suppliers,”
concluded that only a limited number of services are provided to
beneficiaries under the dispensing fee. But AAHomecare countered
that the report has “serious flaws,” noting that it didn’t include
pharmacy, order processing, packaging and shipping, delivery,
billing or any administrative costs related to dispensing the
drugs.