Competitive Acquisition Program Christian G. Downs, JD, MHA Executive Director Association of Community Cancer Centers

1. Competitive Acquisition Program Christian G. Downs, JD, MHA Executive Director Association of Community Cancer Centers

2. CAP • No prescription drug coverage under the Medicare program • Studies showed an overpayment for drugs • MMA 2003 had several payment adjustments

3. CAP • Available to physicians who administer drugs in their office under Part B • Acquire drugs from vendors rather than purchase • Program is voluntary

4. CAP • A single national distribution area • A single drug category for 181 drugs give “incident to” • The physician/vendor enrollment process

5. CAP • No change in coverage • No change in out of pocket cost • CMS thinks that long term costs could decrease somewhat

6. CAP • Participation is voluntary • Physician enrolls with vendor • Vendor delivers drug • Physician bills Medicare for professional and administrative services • Vendor bills Medicare for drug

7. CAP • CMS has set out standards for vendors • Vendor must then apply to Medicare program • Vendor will be selected based on bid price

8. CAP • Not going into effect until July of 2006 • Not popular with physicians as designed • Not popular with vendors as designed • Cost is issue attempting to be addressed

9. REMEMBER • "One of the penalties for refusing to participate in politics is that you end up being governed by your inferiors." -Plato Christian G. Downs, JD, MHA Executive Director Association of Community Cancer Centers (301) 984-9496 ext 220 cdowns@accc-cancer.org