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Senate Bill to Protect Patients' Healthcare by Amending Medicare Coverage
Date:6/11/2009

- Members of Congress Seek to Stem Growing Healthcare Coverage Shortfalls -

WASHINGTON, June 11 /PRNewswire/ -- The U.S. Senate has introduced a bill, S. 1221, "The Medicare Prompt Pay Correction Act," a companion bill to H.R. 1392, which was introduced in the U.S. House of Representatives and currently has 45 co-sponsors.

The Senate bill was introduced by Senators Arlen Specter (D-PA) and Pat Roberts (R-KS). The bill is a step forward in addressing problems with Medicare reimbursement for cancer drugs and in alleviating a national problem affecting the delivery of cancer care treatment to patients, almost all of whom are treated in community oncology clinics close to their homes.

"Community cancer clinics play a critical role in our nation's fight against cancer, especially in rural areas where families do not have access to larger centers," said U.S. Senator Arlen Specter (D-PA). "I am pleased to introduce this legislation which will help ensure access for Medicare beneficiaries' to potentially life-saving cancer treatments."

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. It excludes 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 and thus endangering patient access to affordable, quality cancer care in their communities.

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

This legislation is an effort to improve
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SOURCE Community Oncology Alliance
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