News in brief - Nov. 24, 2003

Medicare drug rule on hold - Rx Depot ordered to close shop - Illinois hospitals investigated

Medicare drug rule on hold

The Centers for Medicare & Medicaid Services will hold off publishing a final rule on payment for physician-administered Part B drugs to see if Congress can pass its own reforms this year.

The agency issued a proposed rule in August with descriptions of four options for reforming the way it pays for the drugs. However, physician groups complained the agency would issue a final rule implementing one of those options without allowing them to comment on the final details.

"That's garbage," CMS Administrator Tom Scully said. "Everybody's known exactly what we're going to do all along. Anybody who says that's not fair hasn't bothered to talk to us."

Scully said the only reason the agency included four options was because of Congress' budgetary rules. Had the agency indicated a single option, the Congressional Budget Office would have ruled that the legislation would not produce much additional savings. By issuing four options, Scully said, Congress can still claim the savings and use them to fund other Medicare reform measures. Scully did not say which option CMS favors.

Rx Depot ordered to close shop

The U.S. District Court for the Northern District of Oklahoma earlier this month ordered Rx Depot and its sister company Rx of Canada to close their stores that help American patients buy prescriptions from Canadian pharmacies. The firms said they would appeal the preliminary injunction from Judge Claire V. Eagan.

The U.S. government sued the companies, saying they violated federal laws that prohibit drugs from being reimported into the United States. The companies argue they are simply assisting patients with paperwork.

Illinois hospitals investigated

Illinois hospitals have come under fire for charging uninsured patients more than insured patients, who generally receive a discounted rate negotiated by their insurance company. State Attorney General Lisa Madigan has decided to investigate whether the hospitals are violating consumer protection laws. She alleges that the facilities are charging uninsured patients inflated rates and pursuing aggressive collection practices, including property seizures.

The Illinois Hospital Assn. recently adopted new guidelines on charity care that recommend its members offer free care to patients with incomes below the poverty level, offer reduced rates to those below 200% of poverty, and forgo legal action when patients clearly can't pay.