Where We Stand
Section: Medicare
Policy: BIPA

BIPA

OMA supports the interpretation of the BIPA 2000 provision that drugs and biologicals which are not usually self-administered by the patient be covered by Medicare in a manner consistent with Congressional intent.

OMA advocates that CMS and its Medicare contractors only exclude a drug or biological from its coverage when there is evidence that the majority of the Medicare patients using that drug are personally self-administering it.

OMA supports the interpretation of the BIPA 2000 provision that Medicare coverage be based solely on the beneficiary’s ability to self-administer drugs and not the ability of family members to administer the needed injection.

OMA asks the AMA to advocate that CMS address the failure of allocation of Part A funds to cover Part B services that have changes from inpatient to outpatient delivery.

Reaffirmed at the interim House of Delegates, 2004.

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