tci Part B Insider - 2004 Issue 9

Off-Label Drugs: Medicare May Slash Coverage For Off-Label Chemotherapy Drug Uses

Your claims for high-price and off-label drugs may come under scrutinyAccording to recent articles in the New York Times and the Boston Globe, the Centers of Medicare & Medicaid Services is conducting a review of coverage for off-label uses of high-priced drugs. And CMS may revoke coverage for some of the most commonly prescribed off-label uses if the review turns out negative. The Globe story, dated Feb. 10, says that CMS is becoming bolder in venturing into the Food & Drug Administration's territory. In the past, Medicare approved off-label uses based on the physician's judgment, but marketing abuses...

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