OPPS blocking access to drugs

Patients have been denied life-saving cancer therapies as a result of the government's new Medicare reimbursement system, biotech companies and healthcare providers told Congress last week.

With the outpatient prospective payment system (OPPS) in place only since Jan. 1, only a small number of patients have reported that the reimbursement scheme has caused hospitals to turn them away. But hospitals haven't yet realized that they are losing money under OPPS because of the time lag between when they receive bills and when they are reimbursed, according to industry executives and physicians. They predicted that the number of complaints will swell as more hospitals realize that they are losing money every time they administer products like Rituxan rituximab or Zevalin ibritumomab tiuxetan radiolabeled antibody.

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