Consolidated billing?

A hospital system has proposed that they "reimburse" us (the SNF) for a medication if a patient is on Medicare. The medication is IV Daptomycin. It is not a chemo drug. It is an expensive antibiotic delivered IV. It appears they are having difficult getting SNF's to accept these resident because of drug cost. So they proposed we provide it and they reimburse for it. I believe this would fall under consolidated billing and would not be allowed. Am I correct?

Comments

  • I'm not sure that this would be allowed, however, when we've run into high cost medications that are not carved out, if the patient has a Medicare Advantage plan, we will approach the health plan to see if they would allow a carve out (case by case basis) and we've been able to have partial medication cost covered in a couple of cases.

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