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National Monitoring Policy for EPO and Aranesp for End Stage Renal Disease (ESRD) Patients Treated in Renal Dialysis Facilities

Medicare is instituting a new national monitoring
policy for claims for erythropoietin and darbepoetin (EPO and Aranesp) for ESRD
patients treated in renal dialysis facilities. Under the new monitoring policy, Medicare
expects a 25 percent reduction in the dosage of the drug for patients whose hematocrit
exceeds 39.0 (hemoglobin of 13.0). If the dosage is not reduced, payment will be made
for the drugs as if the reduction had occurred. Also a new maximum limitation for each
drug per month is created.

Download the Guidance Document

Issued by: Centers for Medicare & Medicaid Services (CMS)

Issue Date: November 10, 2005

DISCLAIMER: The contents of this database lack the force and effect of law, except as authorized by law (including Medicare Advantage Rate Announcements and Advance Notices) or as specifically incorporated into a contract. The Department may not cite, use, or rely on any guidance that is not posted on the guidance repository, except to establish historical facts.