Payments For Epogen Administered at University of Virginia Medical Center-Lynchburg Dialysis, Lynchburg, Virginia

摘要

Pursuant to Title XVIII of the Social Security Act (the Act), the Medicare program provides health insurance for people 65 years of age and older, people under 65 with certain disabilities, and people of all ages with end-stage renal disease (permanent kidney failure requiring a kidney transplant or dialysis). The Centers for Medicare & Medicaid Services administers the program. Section 1881(a) of the Act establishes the benefits provided by Medicare Parts A and B for individuals who have been determined to have end-stage renal disease as provided in section 226A of the Act. Benefits include injections of Epogen, usually administered during dialysis. Individuals diagnosed with end-stage renal disease often suffer from anemia, and Epogen lessens the effects of anemia for those patients. Epogen doses are generally adjusted by a physician based on a review of the patient's medical record. For facilities that use a preestablished dosing algorithm, a nurse may also adjust the Epogen dose to maintain an optimal hematocrit (red blood cell) level.