Medicare beneficiaries may have difficulty keeping track of their coinsurance amounts, “and they may not be inclined to pay a vendor with whom they only have an impersonal business relationship,” Mr. Melville cautioned.
The trade group did not make any comments directly on the competitive acquisition program.
The interim rule creating the new program took effect in June, although CMS will be seeking additional comments until Sept. 6. The agency plans to receive bids from vendors later this summer and award contracts in early fall, in anticipation of starting the program in 2006.
For more information about the competitive acquisition program, go to www.cms.hhs.gov/providers/drugs/compbid
A Look at the Covered Drugs
More than 180 drugs billed incident to a physician's service and paid for under Part B of Medicare will be part of the competitive acquisition program. These agents account for 85% of all Medicare spending on physician-injectable drugs and include agents commonly administered by rheumatologists, such as:
▸ Cyclophosphamide (both lyophilized and nonlyophilized).
▸ Hylan G-F 20 (for intraarticular injection).
▸ Infliximab (injection).
▸ Methylprednisolone acetate (injection).
▸ Methylprednisolone sodium succinate (injection).
The new program will not apply to drugs included in the new prescription drug benefit under Medicare Part D, nor will it apply to drugs that are self-administered by the patient through a device such as a nebulizer or to certain other drugs, such as intravenous immunoglobulin, immunosuppressants, and hemophilia blood-clotting factor.