[Congressional Record Volume 148, Number 103 (Thursday, July 25, 2002)]
[Senate]
[Page S7374]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mr. KERRY:
  S. 2795. A bill to amend title XVIII of the Social Security Act to 
provide for payment under the prospective payment system for hospital 
outpatient department services under the medicare program for new drugs 
administered in such departments as soon as the drugs administered in 
such departments as soon as the drug is approved for marketing by the 
Commissioner of Food and Drugs; to the Committee on Finance.
  Mr. KERRY. Madam President, I am pleased to introduce legislation 
today that will fix a flaw in Medicare's claims processing system that 
currently denies thousands of cancer patients timely access to 
lifesaving treatments. This legislation will ensure that administrative 
delays do not force Americans with cancer to wait to be treated with 
existing innovative drug therapies that stand to improve and prolong 
their lives.
  The Food and Drug Administration, FDA, recently granted fast track 
authority to a new class of cancer therapies. These therapies, which 
combine immunotherapy and radiological treatments, offer promise and 
hope for many cancer patients. Under current Medicare policy, however, 
reimbursement for FDA-approved drugs in an outpatient setting does not 
begin until Medicare issues a billing code for the drug. Consequently, 
there is often a delay of several months between FDA approval of and 
patient access to a drug.
  Prior to the designation of a Medicare billing code, doctors will not 
prescribe innovative treatments for patients in an outpatient setting 
for fear of their being denied reimbursement by Medicare. However, 
within the inpatient setting, Medicare will reimburse hospitals 
immediately after FDA approval. Given this discrepancy in current 
policy, I am introducing legislation that will allow doctors to submit 
claims retroactively and require Medicare to pay for innovative drugs 
administered in hospital outpatient settings immediately after FDA 
approval.
  Cancer patients cannot afford to wait for drugs that have the 
potential to improve their health and even save their lives. For 
Americans battling cancer, time is of the essence. This legislation 
will provide cancer patients with both the hope and the opportunity to 
live longer and healthier lives. I urge my colleagues to join me in 
support of this legislation.
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