House Members Ask CMS To Allow Medicare Beneficiaries to Receive Coverage for Certain Self-Injected Prescription Drugs

Members of the House Energy and Commerce Committee, including Chair Billy Tauzin (R-La.) and ranking member John Dingell (D-Mich.), have written a letter urging CMS to implement provisions in a law passed in 2000 to reimburse Medicare beneficiaries for certain self-injected prescription drugs, CongressDaily/AM reports. In a letter to CMS Administrator Thomas Scully last week, committee members outlined provisions in the Medicare, Medicaid, and SCHIP Benefits Improvement and Protection Act of 2000 (HR 5661) that allow beneficiaries who self-administer injections of some prescription drugs to receive reimbursement under Medicare. Under past interpretations of Medicare law, CMS only reimbursed beneficiaries for prescription drugs administered by a health care professional, which forced some patients to visit a physician for routine injections. "Despite the explicit directions provided by Congress in BIPA, CMS has not yet issued a program memorandum notifying Medicare contractors of a change in the law," the letter said, adding, "An unfortunate consequence of this inaction is that Medicare beneficiaries continue to be denied access to drugs and biological products, solely upon the basis that the product could be self-administered" (CongressDaily/AM, 2/12).