Know the Bills
Legislation We Support
HR 460 Patients Access to Treatments Act of 2013
The goal of HR 460 is to limit the dollar amount of cost sharing in Specialty Tier drugs. An example of Specialty Tier drugs would be any of the new biologics.
HR 991 Virtual Colonoscopy Act
The goal of HR 991 is to cover screening computed tomography colonography (virtual colonoscopy) as a colorectal cancer screening test under the Medicare program.
The SCREEN Act (S. 608/H.R. 1320)
The goal of HR 1320 is to ensure patients aren’t hit with unexpected medical bills by waiving Medicare beneficiary cost-sharing for colon cancer screenings in which polyps are removed during colonoscopy.
Removing Barriers to Colorectal Cancer Screening Act HR 1070
HR 1070 also seeks to close the colonoscopy loophole.
Issues We’re Involved With
The Colon Cancer Alliance helps nearly one million individuals affected by colon cancer each year and wants its patients to have access to the best treatment options available. However, cancer treatment costs are increasingly burdensome. The median price for cancer treatment today is around $10,000 per month. The out-of-pocket costs for patients are also escalating. That said, should managed care and medical providers make decisions for patients based solely on what they think a patient can afford?
This is how CMS (Medicare) reimburses for outpatient chemo. The physician is reimbursed for the Average Sales Price (ASP) of the chemotherapy plus 6% to cover the cost, but this may be lowered to 4% or lower to save money. Lowering the reimbursement will discourage oncologist’s offices from taking new Medicare patients.
Medicare 340B is how indigent care is supposed to be funded. Pharma has to sell drugs at a steep discount to qualified hospitals (known as Disproportionate Share Hospitals or DSH). DSH sell these drugs at normal prices. The profit is supposed to cover indigent care. The concern is that hospitals are using it to pay the bottom line.
Other Issues You Should Know About
The Government Shutdown and the Effect on Cancer Patients
This is the equivalent term for generic but with biologic as opposed to chemical medicines. The issue is that biologics are way more complex. Aspirin is chemically all the same. Biologics aren’t. Little changes in manufacturing can make big differences. Think $100 bottle of wine vs. $5 wine. They’re both fermented grapes, right? But it can be done. We want biologics that are safe and affordable.
HR 1549 Helping Sick Americans Now Act
HR 1549 takes money from a prevention fund to pay for the extension of pre-existing condition insurance.
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