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House Bill to Improve Accuracy of Medicare Reimbursement Introduced: Members of Congress Seek to Stem Growing Healthcare Coverage Shortfalls, Community Oncology Alliance Advocates for Swift Passage of Bill
Date:3/10/2009

WASHINGTON, March 10 /PRNewswire-USNewswire/ -- Representatives Gene Green (D-TX), Ed Whitfield (R-KY), Mike Ross (D-AR), Ed Towns (D-NY), Diana DeGette (D-CO), Mike Rogers (R-MI), Betty Sutton (D-OH), Bart Gordon (D-TN), Lee Terry (R-NE) and Ralph Hall (R-TX) today introduced H.R. 1392.

This bill will amend title XVIII of the Social Security Act to ensure more appropriate payment amounts for drugs and biologicals under Part B of the Medicare Program by excluding customary prompt pay discounts extended to wholesalers from the manufacturer's Average Sales Price (ASP). These discounts artificially reduce Medicare Part B drug reimbursement rates for community oncology clinics, jeopardizing the viability of these providers. The bill is a step forward in addressing problems with Medicare reimbursement for cancer drugs.

"This bipartisan bill is imperative for millions of Americans across the nation to have access to treatment at community oncology clinics and to the life-saving medications they need," said U.S. Rep. Gene Green (D-TX).

Excluding distributor prompt pay discounts from the ASP methodology is consistent with existing policy and will create greater uniformity among federal healthcare programs, as these terms already are excluded from the Medicaid Average Manufacturer Price (AMP) methodology.

The U.S. has the best cancer care delivery system in the world, in which 84 percent of Americans receive quality, compassionate care in community cancer clinics. However, the cancer care delivery system is now in first-stage crisis because Medicare has substantially cut payment for cancer drugs and essential services.

Community cancer clinics have had to close satellite facilities and cut staff. Smaller clinics are struggling to operate and more will close. Patients with insufficient or no insurance, especially seniors covered by Medicare, are increasingly
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SOURCE Community Oncology Alliance
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