It's important to keep an eye on the health insurance claims filed by your doctors or clinics. Sometimes the wrong CPT code can be written on the claim by the doctor's office and you or your insurance company will be charged for something that may not have been done. I have found out that they cannot charge you or your insurance for an "office visit" unless you actually saw the doctor. Just an FYI!

Date: Thu, 2 Aug 2007 08:09:04 EDT
From: Gary Takata
Subject: Medicare/ anemia drugs access

August 2, 2007

Amgen Challenges New Medicare Policy
By REUTERS
LOS ANGELES, Aug. 1 (Reuters) Amgen has challenged a portion of a new
coverage policy issued by the agency that runs Medicare, saying it will limit
cancer patients access to drugs that fight anemia.
On Monday, the federal agency, the Centers for Medicare and Medicaid
Services, eased some of the restrictions it had proposed in May for the use of anemia
drugs in cancer patients. The agency was concerned that the products might be
making some cancers worse, but relented in the face of an outcry from cancer
patients and their doctors.
But the agency also said it would deny payment for drugs like Aranesp and
Epogen from Amgen and Procrit from Johnson & Johnson if a patients hemoglobin
level was greater than 10 grams per deciliter.
Many doctors aim for a hemoglobin level of 10 to 12 grams per deciliter in
their cancer patients (the normal range is generally 13 to 18 grams per
deciliter for men and 12 to 16 grams per deciliter for women).
Amgen said it was concerned that the new limits on coverage would increase
the need for blood transfusions and compromise quality of care.
In our view, restricting coverage in this way is unreasonable, impractical
and unworkable, Dr. Roger M. Perlmutter, Amgens executive vice president for
global research and development, said.
The company added that limiting reimbursement to patients with hemoglobin
levels of less than 10 grams per deciliter is contrary to the Food and Drug
Administrations approved labeling for the drugs, which stimulate the bodys
production of erythropoietin, a hormone needed in the production of red blood
cells.
Amgen, whose Aranesp and Epogen were last years best-selling biotech drugs,
also said the new policy goes against a recommendation by the Oncologic Drugs
Advisory Committee against changing the upper hemoglobin limit of 12 grams per
deciliter in the current F.D.A. label for its drugs and in clinical practice
guidelines from the American Society of Clinical Oncology and the American
Society of Hematology.
In March, the F.D.A. put its strongest warning on the label of Aranesp and
similar anemia drugs, calling on doctors to use the lowest dose that can
effectively avert the need for blood transfusions, because of concerns over safety
and overuse.
Last month, the Medicare agency also proposed reducing payments for anemia
drugs used to treat patients who are undergoing kidney dialysis.
Shares of Amgen lost 3.07 percent, or $1.65, to close at $52.09 Wednesday on
Nasdaq.

Hom