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Medicare Payment

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(May 31, 2002)

May 31, 2002

Dear Senator/Representative:

The Cancer Leadership Council, representing cancer patient, provider, and research organizations, is writing to urge your support for legislation that would eliminate delays in Medicare reimbursement for new drugs and biologicals that are administered in the hospital outpatient setting. If cancer patients are to have timely access to promising new therapies, Medicare pass-through payments must be made from the date of Food and Drug Administration (FDA) approval of a drug or biological.

Unfortunately, the treatment options for a number of cancers remain quite limited, and new treatments are critical to advancing the quality of care for many cancer survivors. Current Medicare policy postpones payment for new therapies in the outpatient setting for a period of months until a reimbursement code is assigned. Because of this Medicare policy, senior citizens are denied access to quality care and developers of new products are sent powerful negative messages regarding the availability of prompt Medicare payment for their products. For a community that depends on rapid advances in care, this payment system is unacceptable.

We urge you to include in Medicare legislation a provision requiring Medicare to begin reimbursing for new drugs and biologicals administered in hospital outpatient departments from the date of FDA approval. Eliminating any impediment to payment for new drugs and biologicals will help ensure that cancer patients have ready access to these therapies.

We look forward to your favorable action on this issue of great importance to cancer patients.


Cancer Leadership Council

Alliance for Lung Cancer Advocacy, Support, and Education
American Society of Clinical Oncology
Association of American Cancer Institutes
Cancer Care, Inc.
Cancer Research Foundation of America
The Children's Cause, Inc.
Coalition of National Cancer Cooperative Groups
Colorectal Cancer Network
The Foundation for the Children's Oncology Group
Kidney Cancer Association
The Leukemia & Lymphoma Society
Lymphoma Research Foundation
Multiple Myeloma Research Foundation
National Coalition for Cancer Survivorship
National Patient Advocate Foundation
National Prostate Cancer Coalition
North American Brain Tumor Coalition
Ovarian Cancer National Alliance
Pancreatic Cancer Action Network
US TOO! International, Inc.
The Wellness Community
Y-ME National Breast Cancer Organization

cc: Senate Finance Committee
House Ways & Means Committee
House Energy & Commerce Committee

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