Bipartisan Congressional Letter Urges CMS To Delay Implementation of OPPS Reduction

WASHINGTON, D.C. - (December 13, 2001) - Sharon L. Cohen, vice president of government relations for the Biotechnology Industry Organization (BIO), released a statement in support of today’s letter from a bipartisan group of Congressional members to the Centers for Medicare and Medicaid Services (CMS). The lawmakers have urged CMS to delay implementing a 68.9 percent reduction in Medicare payments for innovative medications used in the outpatient hospital setting.

“We applaud Reps. Bill Thomas (R-CA), W.J. “Billy” Tauzin (R-LA), Charles B. Rangel (D-NY), John D. Dingell (D-MI), Nancy L. Johnson (R-CT), Michael Bilirakis (R-FL), Pete Stark (D-CA) and Sherrod Brown (D-OH), and Sens. Max Baucus (D-MT) and Charles Grassley (R-IA), for requesting a delay in CMS’s implementation of the pass-through payment reduction.

“The pass-through payment pool was mandated by Congress to increase Medicare patient access to innovative treatments and technology in the outpatient hospital setting.

“However, the 68.9 percent pro-rata reduction will bring reimbursement for such treatments and technology well below true hospital acquisition cost. This, in turn, may severely restrict Medicare patient access to potentially life-saving therapies.

“These Congressional members recognize that the CMS data used to derive the 68.9 percent reduction may be flawed, and delaying the rule’s implementation will give CMS time to correct errors and reimburse correctly.

“We stand with these members of Congress and ask CMS to delay the implementation of the pass-through payment reduction until more reliable data is obtained and examined. And, we ask the agency to recognize that patient access to innovative drugs and biologics for rare diseases will be significantly harmed if this final rule is implemented. Typically, patients that suffer from rare diseases are treated with drugs and biologics that offer no price differential due to the low patient population that they serve. Ironically, these patients would be harmed the most from the 68.9 percent pro-rata reduction, which trumps Congress’ original intent of the pass-through pool."

BIO represents more than 1,000 biotechnology companies,academic institutions, state biotechnology centers and related organizations in all 50 U.S. states and 33 other nations. BIO members are involved in the research and development of health-care, agricultural, industrial and environmental biotechnology products.

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