Erythropoietin claims monitoring policy: implications for clinical practice

The revised erythropoietin claims monitoring policy that will govern reimbursement by the Centers for Medicare & Medicaid Services for Epoettin alfa and darbepoetin alfa administered to patients on dialysis takes effect on April 1, 2006. The new policy provides several significant improvements that should enhance clinicians' ability to manage anemia rationally. However, several aspects of the new policy are ambiguous and will require further clarification and ongoing evaluation to determine the effect on practice patterns and clinical outcomes.