The new Medicare Prescription Drug Bill has made managing your practice assets more important than ever before.

Under the new reimbursement formulas, most medical oncologists will lose money treating their Medicare patients in the office starting in 2004 and beyond. ASCO, COA and AOHA all believe that your practice is in danger.

With 2004 reimbursement scheduled to go as low as 80% of April 1, 2003, AWP and 2005 reimbursement at ASP + 6%, the old ways of doing things may just put you out of business. The increase in payments for administration procedures will not begin to make up for the difference in drug reimbursement.

No longer can you afford to “write-off” the co-pays of those Medicare patients without secondary coverage. No longer can you afford to treat indigent patients in the office, even when you get the drugs free from drug company programs for needy patients. Every patient must pay their way at these new levels of drug reimbursement. And don’t fool yourself; the private payers will be lined up right behind Medicare in reducing drug payments. It’s more important than ever before that your business and financial procedures are as up to date as today’s targeted chemotherapy regimens.

Many of our clients have expressed their concerns about the new Medicare Prescription Drug bill and its impact on community cancer care and their practices ability to continue to provide in-office chemotherapy to their Medicare patients. We must continue to lobby Congress to make changes to the drug reimbursement rules that will pay us less than cost for some drugs in 2004 and for most drugs in 2005 and beyond. At the same time, streamlining office procedures to minimize the impact of these cuts is of utmost importance.

Vista Group has designed its services around the needs of Medical Oncology practices to assist them to survive these massive cuts in Medicare reimbursements. See the “Success” we have achieved for our medical oncology clients.

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COA released a new Medicare Bill Analyzer to estimate the impact the Medicare Prescriptions Drug Bill will have on your practice.  It provides a standard Excel® spreadsheet that you can fill in with your own practice numbers to get a feel for the 2004 and 2005 impact of the new Medicare legislation.


Medicare releases updates to Part B drug reimbursement effective 4.01.04

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CMS announces a new HIPAA update with a web-cast and free tools designed to help practices better understand and train employees on HIPAA regulations.

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Medicare revises 2004 drug reim-bursement schedule based on 4/1/03 AWP.

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Medicare releases 2004 physician reimbursement updates in memo CMS-1372-IFC

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