Chemotherapy Drugs Categorized as ‘In-Office Ancillary Services’

April 1, 2001
Volume 15, Issue 4

Not only has the Health Care Financing Administration (HCFA) backed off on threats to reduce Medicare and Medicaid payments to oncologists for in-office chemotherapy infusion drugs, but now HCFA is making it clear that oncologists can

Not only has the Health Care Financing Administration (HCFA)backed off on threats to reduce Medicare and Medicaid paymentsto oncologists for in-office chemotherapy infusion drugs, but now HCFA is makingit clear that oncologists can provide those drugs to patients without runningafoul of federal self-referral rules. Those rules actually became law in 1993thanks to Rep. Pete Stark (D-Calif), who sponsored the bill that made it illegalfor physicians to refer patients for 10 categories of medical services if thephysician or a member of his family had a financial interest in that serviceprovider. An exception was made for physicians referring patients intra-officefor ancillary services, but when HCFA issued the proposed rule a few years ago,it was unclear whether chemotherapy drugs would be included in the exemption.When HCFA issued the final rules this past January, it was clearly explainedthat chemotherapy infusion drugs were to be considered exempt.