Press Release             

Contact: Nathan Heggem
Policy and Communications Associate

March 11, 2011

Statement by Medicare Rights Center President Joe Baker on the Re-Introduction of the
Part D Off-Label Prescription Parity Act

New York, NY—Monumental advances have been made this week for Medicare consumers who require safe and effective medications used for off-label purposes, the coverage of which has been an issue since Part D began. Not only has a federal court in the Southern District of New York found that the Centers for Medicare & Medicaid Services’s (CMS’s) interpretation of the law is too restrictive, but U.S. Representatives Thornberry and Carnahan have taken legislative action to clarify the Medicare off-label coverage policy by re-introducing the Part D Off-Label Prescription Parity Act. This legislation takes a balanced approach to addressing patients’ treatment needs while ensuring that safety and efficacy are taken into account when determining if Medicare Part D should cover a requested off-label drug. 

Building off of a provision that in 2009 clarified the coverage standard for drugs that are prescribed off label to treat cancer, the Act makes clear that the same coverage standard should apply across the program. Currently, people seeking Part B or Part D coverage for off-label cancer drugs are able to offer support found in peer-reviewed medical journals such as the New England Journal of Medicine, while those seeking medications for non-cancer treatments are left without recourse.

Read Medicare Rights Center’s letter of support for the Part D Off-Label Prescription Parity Act

Read more about the decision in the Southern District of New York.

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Medicare Rights Center is a national, nonprofit consumer service organization that works to ensure access to affordable health care for older adults and people with disabilities through counseling and advocacy, educational programs, and public policy initiatives.


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