HR 1392 Concepts Incorporated into House Health Care Reform Legislation
Provision Would Better Align ASP Drug Reimbursement with Actual Cost
Through the leadership of Reps. Gene Green (D-TX), Ed Whitfield (R-KY), Diana DeGette (D-CO), Mike Rogers (R-MI) and a bipartisan group of over 60 additional co-sponsors, the House Energy & Commerce Committee has amended HR 3200, the America's Affordable Health Choices Act of 2009, to incorporate the concepts of HR 1392, the Average Sale Price (ASP) prompt pay discount fix.
As this provision requires significant new government spending to increase Medicare payments for office-administered drugs, it will take a concerted effort to keep it in the final health care reform legislation that may be passed by the Congress later this year. Please contact your Members of Congress today to express your support for keeping this provision in HR 3200.
HR 1392 is endorsed by ACCC, Amerisource Bergen, ASCO, COA, Curascript Specialty Distribution, HDMA, Health Coalition, Inc., McKesson Corporation, Patient Services Incorporated, SBDA, SGO, UPMC Cancer Centers and US Oncology.
Drug manufacturers are currently required to net out prompt pay discounts paid to wholesale distributors before reporting ASP figures to the Centers for Medicare and Medicaid Services (CMS), even though the wholesaler prompt pay discount is not passed along to physicians. Physician drug reimbursements are lowered by approximately two percent by this provision in the ASP calculation, which is the customary amount of the wholesale distributor prompt pay discount.
With the support of House Energy & Commerce Committee Chairman Henry Waxman (D-CA), the committee has amended HR 3200 to include Section xxxx, which will clarify the ASP statute by removing "customary prompt pay discounts extended to wholesalers" from the list of price concessions that reduce ASP.
Here is a comparison of the provisions of HR 1392 as it was introduced with the ASP prompt pay discount provision currently included in HR 3200:
HR 1392 clarifies the ASP statute by removing "customary prompt pay discounts extended to wholesalers" from the list of price concessions that reduce ASP;
HR 3200 clarifies the ASP statute by removing "customary prompt pay discounts extended to wholesalers" from the list of price concessions that reduce ASP.
HR 1392 would be effective January 1, 2010 and remain in effect indefinitely;
The ASP prompt pay discount provision in HR 3200 would be effective January 1, 2011 and remain in effect until January 1, 2016;
HR 1392 does not limit the amount of the wholesaler prompt pay discount that would be excluded from the ASP calculation;
The ASP prompt pay discount provision in HR 3200 limits the amount of the wholesaler prompt pay discount that would be excluded from the ASP calculation to 2% of wholesale acquisition cost; it does not prohibit wholesaler prompt pay discounts in excess of 2% of wholesale acquisition cost but instead limits the amount that may be excluded from the ASP calculation;
The Senate version of HR 1392 is S 1221, introduced recently by Senators Specter and Roberts, and now has 5 Senate co-sponsors. US Oncology strongly supports S 1221 and HR 1392 and will continue to work closely with Sens. Specter and Roberts and Reps. Green, Whitfield, DeGette and Rogers, along with the other Congressional champions of community cancer care and the broader community oncology and specialty distribution coalition to move this important legislation forward in the 111th Congress.
Click here to find your Representatives to ask them to keep the ASP prompt pay discount fix in HR 3200 and to find your Senators and ask them to co-sponsor S 1221.
Click here to read the community oncology and specialty distribution letter to the U.S. House and Senate leadership.
Click here to review S 1221. |