Executive Summary

Proposed regs to set a per diem fee schedule for the ancillary services associated with home I.V. drug delivery under the Medicare outpatient drug program should be ready by the Spring of 1989, according to HCFA Office of Reimbursement Director Charles Booth. Booth told a Sept. 15 conference on Medicare coverage and reimbursement that the Health Care Financing Administration will have to try to have the proposed regs out early next year if the final rules are to be ready by the Fall of next year. That deadline is necessary so that HCFA can have the benefit ready to start by Jan. 1990, as specified by the Catastrophic Care Act. "There are a number of considerations that we will have to make in order to set up this fee schedule," Booth observed. One of the key questions,he said, will be the level of training a person needs to administer the therapy. Another issue will be the length of therapy. Transportation costs, supplies, inventory and overhead will also need to be addressed. HCFA is also prepared to look into safety needs, such as special preparation, handling and disposal of cytotoxins. Booth said HCFA expects there "will be significant comments regardless of what we come up with." He said that the "rulemaking process will be very important for this particular benefit."