Law & Health Weekly
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Centers for Medicare & Medicaid Services
Unclassified, FDA-approved drugs administered to outpatients will be reimbursed
June 26th, 2004
In an effort to ensure that Medicare beneficiaries have prompt access to the latest drugs used in conjunction with a covered hospital outpatient service, the U.S. Centers for Medicare & Medicaid Services (CMS) has issued instructions telling the contractors that process claims under the hospital outpatient prospective payment system (OPPS) how to pay for new drugs that have been approved by the U.S. Food and Drug Administration, but have not yet been assigned a product-specific HCPCS billing code. The instructions, which implement a provision of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA), authorize payment for drugs and biologicals...
Source: Law & Health Weekly (2004-06-26)
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