As a result of recent developments affecting Medicare reimbursement for certain respiratory drugs, the Company is revising its previous guidance for the expected impact on the Company's revenues from Medicare price reductions taking effect in 2008. The Company now estimates that revenues in 2008 will be negatively impacted by approximately $100 million compared with its previous guidance of $65 million to $70 million of Medicare price reductions.
On April 10, 2008, the Durable Medical Equipment Medicare
Administrative Contractors (DME MACs) issued a revision of the Nebulizer
Local Coverage Determination (LCD) that effectively eliminates coverage for
certain respiratory drugs dispensed by the Company's pharmacies to its
customers. The effective date of the revised coverage policy is July 1,
2008. The Company's previous guidance took into account anticipated
reductions in payment amounts for respiratory drugs arising from continued
fluctuations in average sales price data used by the Centers for Medicare
and Medicaid Services to establish quarterly payment rates and from
mandated adjustments to the calculation methodology used to price such
drugs effective April 1, 2008, the continuing effect of changes in the
payment methodology for items of durable medical equipment in the capped
rental payment category which began to take effect in 2007, the impact from
the commencement of a competitive acquisition program in ten large
metropolitan markets beginning on July 1, 2008 and a 0.4% increase in the
monthly payment amount for stationary oxygen equipment which took effect on
January 1, 2008. Based on the expect
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