(April 6, 2000)

April 6, 2000

The Honorable Thomas J. Bliley, Jr.
House of Representatives
2409 Rayburn House Office Bldg.
Washington, D.C. 20515

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
Cancer Care, Inc.
Cancer Research Foundation of America
Cure For Lymphoma Foundation
National Coalition for Cancer Survivorship
National Patient Advocate Foundation
Oncology Nursing Society
Ovarian Cancer National Alliance
Susan G. Komen Breast Cancer Foundation
US-TOO International, Inc.
Y-ME National Breast Cancer Organization
Multiple Myeloma Research Foundation
National Prostate Cancer Coalition

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