US Senators launch Bill to correct Medicare drug reimbursement

9 May 2011

A bipartisan bill, S 733, designed to address a Medicare reimbursement flaw and seeking to reverse cancer care payment shortfalls has been introduced in the USA by Senator Pat Roberts (Republican, Kansas) and lead co-sponsor Senator Debbie Stabenow (Democrat, Michigan).

The bill proposes to amend title XVIII of the Social Security Act to ensure more appropriate payment 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).

Currently, the ASP methodology used to calculate Medicare Part B reimbursement artificially reduces payment for cancer drugs to community oncology practices. This often results in a reimbursement that is insufficient to cover the cancer drug purchase cost, forcing practices to pay out of pocket for treating cancer patients with chemotherapy.

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