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No. 20
Old Aug 11, 2007, 09:43 PM

Default Re: Medicare Question
Originally Posted by woody62 View Post
Yeb, I am sure that the facility I was in got their drugs from an area pharmacy. I had a medication changed and when I requested it, I was told they had to send someone to the pharmacy they use, to obtain it. I also was at the nurse's station, waiting for my turn at P.Y., when I observed a person enter and leave several big bags at the station. I asked what was in them and was told there were patients medications in them. And I watched, as a nurse emptied them and put them in patients drawers, in the med cart.

Now it is possible that I had experience short and long term memory loss and imagined the entire episode. But I don't think so.

Woody

And by the way, my roommate's daughter works at a local LTC facility, as a nurse. I recently asked her about how they obtained their drugs. She told me the same thing that I had witnessed. And she worked at a different facility. Perhaps it is something local to Charlotte County.

Oh but my comment didn't apply to WHERE the meds came from (they can come from ANYWHERE the facility decides to contract with.... my point was that the FACILITY ultimately paid the pharmacy, not medicare paid the pharmacy.
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No. 21
Old Aug 11, 2007, 09:51 PM

Default Re: Medicare Question
Originally Posted by woody62 View Post
I would love to post a copy of my bill from the LTC facility I was in. As well as copies of my Medicare Part D payouts. To answer your question, my Part D was billed by the pharmacy that provided all of my medications while I was in the LTC facility, as well as the p[provider for the IV solutions I received after being discharge back to the LTC facility. I cannot find any billing to Medicare, from the facility, for any of the drugs and IV's I received.


Woody

Well this is just plain screwy, cuz this is not how it works! Maybe you got ripped off?? Medicare covers the first 20 days in LTC at 100%, the other 80 days are covered at 80% and the resident is billed a predetermined (amount determined on a regional basis I believe) amount for the other 20% - currently ours would run about $140/day I think. Thats it - that is all the bill a resident receives. There wouldn't even be a reason to send the resident any kind of bill for pharmacy services or any information as to how it got paid... it wouldn't be their worry!

Again... this is for those on medicare A only, this does not include private pay or medicaid individuals.
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No. 22
from woody62
Old Aug 11, 2007, 10:02 PM

Default Re: Medicare Question
Originally Posted by Nascar nurse View Post
Oh but my comment didn't apply to WHERE the meds came from (they can come from ANYWHERE the facility decides to contract with.... my point was that the FACILITY ultimately paid the pharmacy, not medicare paid the pharmacy.
And my answer is that my Part D provider paid the pharmacy. No where, on any of my bills, from the LTC facility, am I charged nor did the facility list a charge from the pharmacy for any of my medications, something they would have to do if they were paying the pharmacy for my drugs.

I do not know how much more clearly I can put this. The pharmacy charge my Part D provider for all the medications I received. A different supplier charged Medicare for my IV antibiotics that I received for two weeks after my readmission. While I was an inpatient, Charlotte Regional billed for my stay. As a matter of fact, they billed over $200,000 to Medicare. Unfortunately for them, they are considered a rural provider. They only received $15,000. And they could only bill me for my Medicare deductable. Kind of a bum deal but it will remain so until they get their designation changed, something all three hospitals have been trying to do for more then 12 years.

Woody
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No. 23
Old Aug 12, 2007, 01:02 PM

Default Re: Medicare Question
Originally Posted by woody62 View Post
Kind of a bum deal but it will remain so until they get their designation changed, something all three hospitals have been trying to do for more then 12 years.

Woody

AHHHH, maybe this is the technicality that we are missing. You refer to a "designation change" and the word "hospitals".

I am referring to an extended care, skilled nursing facility only. I am not familiar with how other "licensed" facilities bill, but I am sure there are differences.
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No. 24
from busy-bee
Old Aug 12, 2007, 10:22 PM

Default Re: Medicare Question
Thanks everyone.........I think this thread now should end.
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No. 25
from woody62
Old Aug 13, 2007, 05:49 AM

Default Re: Medicare Question
Originally Posted by Nascar nurse View Post
AHHHH, maybe this is the technicality that we are missing. You refer to a "designation change" and the word "hospitals".

I am referring to an extended care, skilled nursing facility only. I am not familiar with how other "licensed" facilities bill, but I am sure there are differences.
Sorry but you misunderstood my post. There are three hospitals here in Charlotte County. All three hospitals are designated rural by Medicare. This means that they are reimbursed by Medicare as rural hospitals. The LTC facilities here are not considered rural by virtue of the fact that they are LTC facilities. They are not designated as rural because they cannot be.

Woody
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