CMS Issues Clarification on Inhalation Drug Dispensing Fee

BALTIMORE–Only one dispensing fee for inhalation therapy drugs
will be payable per 30- or 90-day period, regardless of the numbers
of suppliers used, CMS clarified in a transmittal last week.

Last month, respiratory providers were dismayed when CMS
announced that it would reduce the dispensing fee for Medicare Part
B inhalation drugs from $57 to $33 per monthly supply in 2006. Each
90-day supply will drop from $80 to $66. The agency will provide an
initial $57 30-day dispensing fee, which is a “one-time fee
applicable only to beneficiaries who are using inhalation drugs for
the first time as a Medicare beneficiary,” CMS said. (See HomeCare
Monday, Nov.7.)

For a refill prescription, Medicare will not pay for a
dispensing fee sooner than seven days before the end of usage for
the current 30- or 90-day period for which a dispensing fee was
previously paid, CMS said in the transmittal. Each inhalation drug
supplier will be allowed no more than 12 months of dispensing fees
per beneficiary per year, and Medicare will not pay separately for
compounding drugs.