Medicare: Radiopharmaceutical Purchase Prices for CMS
Consideration in Hospital Outpatient Rate-Setting (14-JUL-05,
GAO-05-733R).
Medicare pays hospitals for drugs and other pharmaceutical
products that beneficiaries receive as part of their treatment in
hospital outpatient departments. Specifically, the Centers for
Medicare & Medicaid Services (CMS) in the Department of Health
and Human Services (HHS) uses an outpatient prospective payment
system (OPPS) to pay hospitals fixed, predetermined rates for
services. These services include pharmaceutical products--drugs,
biologicals, and radiopharmaceuticals--given to beneficiaries in
outpatient settings. When OPPS was first developed as directed by
the Balanced Budget Act of 1997, the rates for hospital
outpatient services and drugs and radiopharmaceuticals were based
on hospitals' 1996 median costs. However, these rates prompted
concerns that payments to hospitals would not reflect the cost of
newly introduced pharmaceutical products used to treat, for
example, cancer, rare blood disorders, and other serious
conditions. In turn, congressional concerns were raised that
beneficiaries might lose access to some of these products if
hospitals avoided providing them because of a perceived shortfall
in payments. In response to these concerns, the Medicare,
Medicaid, and SCHIP Balanced Budget Refinement Act of 1999
authorized pass-through payments, which are a way to augment, on
a temporary basis, the OPPS payments for newly introduced
pharmaceutical products first used after 1996. The Medicare
Prescription Drug, Improvement, and Modernization Act of 2003
(MMA) modified this payment method for some of these
pharmaceutical products. As part of the modification, the MMA
defined a new payment category--specified covered outpatient
drugs (SCOD)--which includes many of these newly introduced
pharmaceutical products. The MMA defined a SCOD as a drug or
radiopharmaceutical used in hospital outpatient departments,
covered by Medicare, and for which CMS has established a separate
ambulatory payment classification (APC) group. The MMA
established a methodology for CMS to follow in setting payment
rates for SCODs in 2004 and 2005. CMS defines SCODs by their
Healthcare Common Procedure Coding System (HCPCS) codes, which
CMS assigns to products, supplies, and services for billing
purposes. The MMA also directed us to collect data on hospitals'
acquisition costs of SCODs and to provide information based on
these data to the Secretary of Health and Human Services for his
consideration in setting 2006 Medicare payment rates. The MMA
directed us to collect these data by surveying a large sample of
hospitals.
-------------------------Indexing Terms-------------------------
REPORTNUM: GAO-05-733R
ACCNO: A30137
TITLE: Medicare: Radiopharmaceutical Purchase Prices for CMS
Consideration in Hospital Outpatient Rate-Setting
DATE: 07/14/2005
SUBJECT: Cost analysis
Data collection
Drugs
Hospitals
Medical services rates
Medicare
Patient care services
Payments
Pharmaceutical industry
Prices and pricing
Procurement
Surveys
Outpatient care services
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