January 21, 2021 – Fantastic news as we start the New Year! Medicare will now cover factor for patients residing in a Skilled Nursing Facility (SNF)! Traditionally this has been a HUGE hurdle for our ageing hemophilia population who require care in a SNF and also need to continue their factor regimen.
A little background: SNFs are provided with a “per diem” rate from Medicare. Within the agreement between Medicare and SNFs, the SNF was historically responsible for the coverage of factor as part of the per diem rate. Since these per diem rates did not come close to covering the cost of high dollar medications, like factor, many patients had difficulty receiving the care they needed in this setting.
The FY21 Federal Funding Bill that was signed into law last month now excludes factor from these per diem rates. This means that if your Medicare patients require a SNF stay, your program may now be able to provide their factor for usage within the SNF while they obtain the care they need.
If you have questions, please feel free to call Holly Frye at 949-223-9828.