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HCFA To Review Medicare Carrier Discretion On Self-Administered Drugs

Executive Summary

HCFA is planning to review the amount of discretion that should be allowed to Medicare carriers on the coverage decisions for self-administerable drugs that were available through Medicare before 1997.

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Medicare coverage of self-injectable products

"South Carolina has the national distinction of being the only state in the U.S. where the Part B Carrier does not cover interferon for any indication...[or] the pre-operative use of epoetin alpha," Greenville, S.C. oncologist Mark O'Rourke told a recent HCFA "town hall" meeting. "The Pink Sheet" incorrectly listed products that O'Rourke considers to be "most-effectively administered by subcutaneous injection," including Amgen's Neupogen, Immunex' Leukine and Ortho's Procrit, as products not covered by the Medicare carrier (1"The Pink Sheet" July 31, p. 10)

Medicare coverage of self-injectable products

"South Carolina has the national distinction of being the only state in the U.S. where the Part B Carrier does not cover interferon for any indication...[or] the pre-operative use of epoetin alpha," Greenville, S.C. oncologist Mark O'Rourke told a recent HCFA "town hall" meeting. "The Pink Sheet" incorrectly listed products that O'Rourke considers to be "most-effectively administered by subcutaneous injection," including Amgen's Neupogen, Immunex' Leukine and Ortho's Procrit, as products not covered by the Medicare carrier (1"The Pink Sheet" July 31, p. 10)

Medicare Carriers Denying Self-Injectable Drug Coverage Despite Mandate

Medicare's South Carolina carrier is refusing coverage for enoxaparin (Aventis' Lovenox), dalteparin (Pharmacia Fragmin) and interferon (Schering-Plough's Intron A) because they can be self-administered, despite a 1999 Congressional mandate requiring coverage, a South Carolina oncologist reported to a May 18 HCFA Town Hall meeting.

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