Kodi Mankhwala Othandizira Ambiri Amatha Kupeza Zotani Zambiri Zamagwiritsidwe Ntchito Mankhwala Osokoneza Bongo?
Patangotha masiku angapo apatsikuli kuti matenda oopsa a fungal meningitis amapezeka chifukwa cha majekeseni oipitsidwa ndi kampani yomwe ikuchita bizinesi monga mankhwala olemetsa, odwala ndi olamulira akufunsa chifukwa chake US Food and Drug Administration sanachitepo kanthu kuti chitetezo cha mankhwala opangidwa mwambo.
Kodi Mankhwala Amagwiritsidwa Ntchito Bwanji?
Zojambula ndi sayansi yokonzekera mankhwala ovomerezeka kwa odwala amatchulidwa ngati mankhwala osokoneza bongo.
Malingana ndi mankhwala a dokotala, mankhwala osokoneza bongo amatha kusakaniza zosakaniza payekha pamodzi ndi mphamvu ndi mlingo woyenera wodwalayo.
Wothandizira Medicare: Mankhwala Osokoneza Bongo
Pambuyo pake, malo osungirako nkhani anafunsa ngati pulogalamu ya Medicare, yomwe inkawoneka kuti inalipira zinthu zambiri zomwe zimaperekedwa kwa odwala omwe akudwala ululu, zitha kulepheretsa vutoli. Mwachitsanzo, bungwe la Associated Press linanena kuti Centers for Medicare & Medicaid Services (CMS) ili ndi malamulo oletsa kulipira mankhwala ambiri omwe amapezeka kuchokera kwa opanga mankhwala.
Papepalayi adalongosola makamaka za chisankho cha CMS chosiya kuika pafupifupi njira zonse zowonjezereka zothandizira kudzera pa nebulizer.
Medicare akupitiriza kubisala mankhwala osokoneza bongo ambiri, koma olemba ndi azimayi ayenera kutsatira malamulo a bungwe kuti athetse odwala oyenerera kutenga mawonekedwe a mlingo omwe akufunikira popanda kulipiritsa ndalama zonse mu thumba.
Mankhwala a Medicare
Kuwonjezera apo, Medicare Part B ikuphatikizapo mankhwala osokoneza bongo omwe amagwiritsidwa ntchito muzipatala komanso malo osungirako chisamaliro. Izi zikuphatikizapo ufa womwe umagwirizanitsidwa ndi saline.
Kupewa Kuwerenga
Kuleka kufotokoza kungabweretse chigamulo cha CMS kapena FDA kuti mankhwala sali oyenera kuchipatala, osalangizidwa mwalamulo kapena opangidwa ndi mankhwala omwe amapanga mlingo wochuluka ngati mankhwala osokoneza bongo.
Buku la Medicare Prescription Drug Benefit Manual la Feb. 19, 2010, likufotokoza mosapita m'mbali malingaliro ndi kufotokoza kwa mankhwala owonjezera omwe amaperekedwa kwa Part D opindula:
Mankhwala osokoneza bongo owonjezera amatha kukhala: (1) zonse zigawo zikuluzikulu za mankhwala D Part D; (2) mbali zina za D Dokotala mankhwala; kapena (3) palibe gawo la D mankhwala mankhwala zigawo zikuluzikulu. Zomwe zimagwirizanitsa ndi zigawo zija zomwe zimakhutitsa tanthauzo la mankhwala a D Part ndilololedwa mu gawo D ....
Ntchito yogwirizanitsa ndi kusakaniza mankhwala opangidwa ndi mankhwala omwe ali ndi gawo limodzi la D Dongosolo la mankhwala akhoza kuphatikizidwa mu malipiro operekedwa. ...
Mafakitale omwe ali ndi mankhwala onse opangidwa ndi ma generic, kugwiritsira ntchito ndalama zowonjezera kuyenera kugwiritsidwa ntchito [ie, kuimbidwa kwa wodwalayo]. Ngati pulogalamuyi ili ndi malonda a dzina lachitsulo, D Part D chothandizira angagwiritse ntchito kugawa kwa ndalama zamagetsi ku chigawo chonsecho.
Kawirikawiri, kuchuluka kwa mankhwala a CMS kwa mankhwala osokoneza bongo amasonyeza gawo B kapena Part D kuchuluka kwa katundu kapena kugulitsa mtengo wa mankhwala omwe ali nawo omwe ali ndi mankhwala omwe amagwira ntchito kuphatikizapo ndalama zomwe zimagwiritsidwa ntchito nthawi zonse. Malipiro a zinthu zinazake amasiyana malinga ndi mitengo ya pamtundu wa mankhwala ndi mankhwala ambirimbiri a API.
Gawo D akukonzanso ndondomeko yobwezeretsa malingana ndi malonda a mgwirizano wa mankhwala. Gawo 20.1.2 la lipotili lotsogolera kulongosola za CMS likufotokozera ziwerengero zoyenera kubwezera.
Momwe Mungayankhire Molondola
Kukonzekera, kupeleka ndi kupereka mankhwala ophatikiza kwa odwala Medicare ayenera kuwerengedwa "chochitika." Izi zikutanthauza, choyamba, kuti wodwala ayenera kukhala akuchiritsidwa ndi adotolo, namwino kapena adokotala ena omwe amadziwika ndi mankhwala a CMS omwe adayankha mankhwalawa. Chachiwiri, mankhwala ozunguliridwa ayenera kugwiritsidwa ntchito ngati mbali ya chithandizo chamankhwala. Mtsogoleli wothandizira makalata olembera omwe amadzitcha kuti wadwala ndi kusokoneza mankhwala omwe amalembedwa pansi pa Gawo B akhoza kulipidwa popanda zovuta.
Pansi pa Healthcare Common Procedure Coding System, kapena HCPS J3490, mankhwala osokoneza bongo amadziwika kuti alibe mankhwala. Zolemba Zamakono Zamakono, kapena CPT, zizindikiro zilipo kwa mitundu yambiri ya mankhwala. Ndi maofesi awiriwa, API iyenera kufotokozedwa.
Nanga bwanji Medicaid?
Kubwezeredwa ndi njira zothandizira mankhwala owonjezera omwe amaperekedwa kwa opindula a Medicaid amasiyana ndi boma ndi boma chifukwa dziko lililonse limagwiritsa ntchito malamulo akuluakulu omwe aikidwa ndi CMS m'njira zosiyanasiyana. Panthawi ya federal, Medicaid imafuna kufalitsa mankhwala osokoneza bongo pamene
- APIs amagwiritsidwa ntchito ndi FDA.
- Mapulogalamu a boma adakhazikitsa malipiro komanso ndalama zowonjezera zomwe zili ndi API.
- Mlingo wopangidwa ndi chizolowezi unakonzedwa ndikuperekedwa malinga ndi lamulo lovomerezeka la wodwala wokhala ndi chidziwitso chokhazikika.
Kufotokozera malamulo a pulojekiti iliyonse ya Medicaid kungatenge bukhu. Nyuzipepala ya National Medicaid Directors imalengeza alendo ku webusaiti ya Medicaid iliyonse, yomwe idzakhala ndi ma ARV okhudza odwala Medicaid.