Reducing Medicare’s payment rates for intermittent urinary catheters can save the program and beneficiaries millions of dollars each year
- Collection:
- Health Policy and Services Research
- Series Title(s):
- Report in brief (United States. Department of Health and Human Services. Office of Inspector General)
- Contributor(s):
- United States. Department of Health and Human Services. Office of Inspector General. Office of Evaluation and Inspections, issuing body.
- Publication:
- Washington, D.C. : U.S. Department of Health and Human Services, Office of Inspector General, August 2022
- Language(s):
- English
- Format:
- Text
- Subject(s):
- Cost Savings Government Regulation Health Expenditures Medicare Urinary Catheters United States
- Genre(s):
- Technical Report
- Abstract:
- Why OIG Did This Review. A 2018 report by the Medicare Payment Advisory Commission found that Medicare paid substantially more than commercial payers for certain items, including intermittent urinary catheters. The report recommended that Medicare incorporate such items into its competitive bidding program, thereby reducing the rates that Medicare allows. However, Medicare has not done so. In fiscal year (FY) 2020, Medicare Part B and its beneficiaries paid $407 million for all intermittent urinary catheters. OIG evaluated whether Medicare’s payment amounts for these catheters may offer the potential for savings. How OIG Did This Review. We sampled 600 Medicare claims from FY 2020, for the three billing categories of intermittent urinary catheters. We requested that suppliers provide and document the acquisition cost for each of the catheters in these claims. We compared the suppliers’ acquisition costs to Medicare payment amounts in three ways: in total, across the three categories, and with regard to three specific features. Additionally, we interviewed the Centers for Medicare & Medicaid Services (CMS) to better understand the methods available to reduce payment rates while maintaining beneficiaries’ access to the catheters that best serve their medical needs.
- Copyright:
- The National Library of Medicine believes this item to be in the public domain. (More information)
- Extent:
- 1 online resource (1 PDF file (30 pages))
- Illustrations:
- Illustrations
- NLM Unique ID:
- 9918715886406676 (See catalog record)
- Permanent Link:
- http://resource.nlm.nih.gov/9918715886406676