LETTER TO COMMERCE AND WAYS AND MEANS COMMITTEES
April 6, 2000
The Honorable Thomas
J. Bliley, Jr.
Dear Representative Bliley:
The undersigned organizations, representing individuals with cancer and their caregivers, are writing to express our appreciation for your interest in Medicare reimbursement for certain injectable drugs and biologicals and to urge your continued aggressive oversight of Health Care Financing Administration (HCFA) actions on this matter.
We applaud your including in the FY 2000 appropriations bill a provision that prevents HCFA from taking actions that would restrict access of Medicare beneficiaries to certain injectable drugs and biologicals. Unfortunately, HCFA did not take prompt action to ensure that its policy is consistent with the Congressional directive, and as a result some patients have continued to face denials of coverage for injectable drugs and biologicals.
We were pleased that on March 17, 2000, HCFA issued a Program Memorandum implementing the FY 2000 appropriations provision. However, the agency has signaled that it will interpret the FY 2000 appropriations provision narrowly. In fact, HCFA has stated that the Program Memorandum on reimbursement for injectable drugs may be "discarded" on September 30, 2000.
Cancer care has been enhanced by new drugs and biologicals, including growth factors for red blood cells, white blood cells, and platelets. Access to these products is considered essential for the effective treatment of cancer patients through drug therapy. It had been the longstanding policy of Medicare to reimburse for these drugs and biologicals if they are usually administered in a physician's office even though they may theoretically be self-injected in some settings. We believe the Congressional directive of 1999 will return us to that policy, which is in the interest of cancer patients and others who depend on injectable drugs.
During the recent hearing of the House Commerce Subcommittee on Health and Environment, it was suggested that the real solution to the injectable drug reimbursement problem is the enactment of comprehensive Medicare prescription drug coverage. We agree that action on prescription drug coverage is necessary. However, it would be anomalous if HCFA should deny access to life-saving drugs and biologicals that are already authorized for Medicare payment at the very time Congress is debating how to expand coverage of prescription drugs for the benefit of patients.
We urge your continued involvement in this issue to ensure responsible action by HCFA.
Cancer Leadership Council
Alliance for Lung
Cancer Advocacy, Support, and Education
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