CMS Will Provide Coverage for Certain Drugs

AUGUST 01, 2004

A new Centers for Medicare and Medicaid Services (CMS) government pilot program will cover a substantial cost of some drugs for 50,000 Medicare beneficiaries who otherwise would have to wait until the Medicare Modernization Act takes effect in 2006. Under the program, the government will spend $500 million to pay for some medications (ie, cancer and multiple sclerosis drugs) that can be taken at home by the patient. Congress has directed that 40% of the funding be allocated for oral anticancer medications.

To be eligible for the program, individuals must meet the following criteria: be enrolled in Medicare Part A and Part B, Medicare must be their primary payer, and they may not have comprehensive drug coverage through other sources.

CMS is accepting applications until September 30, 2004. Participants will be randomly selected from the cancer and noncancer groups.


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