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drug if they had a patient population that would benefit from
that drug.
PC's computer system kept a constantly updated record of
each clinic's stock of chemotherapy drugs and ancillary
pharmaceuticals. Drug orders were placed automatically and
electronically by computer when the onhand quantity of a
particular drug dropped to a predetermined minimum balance.
Petitioners’ software only tracked drugs.
The shelf lives for chemotherapy drugs varied from about 6
months to 1 year in an unmixed state. A mixed or prepared
chemotherapy treatment generally had to be used within 3 to 24
hours.
Billing and Reimbursement
Each time a patient visited a clinic for treatment, a nurse
completed a charge sheet. The charge sheet was then used to bill
the patient or the party primarily responsible for payment. The
charge sheet indicated the patient's diagnosis and the amounts of
chemotherapy drugs administered, as well as any other medications
or procedures used in treating the patient on that day. After
the patient's treatment for that day was complete, the charge
sheet was forwarded to the billing department at PC to determine
the amount to be charged or billed.
Most clinic patients had Medicare or private insurance
coverage. For such patients, petitioners filed for payment
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Last modified: May 25, 2011