How the CAP Vendor Proposes to Fix CAP

The CEO of the sole specialty pharmacy vendor for the Medicare Part B Competitive Acquisition Program (CAP) testified at the July 13 hearing of the House Ways and Means Subcommittee on Health hearing about how to address problems that may account for the very low participation in the program. Only 307 physicians had signed up as of July 10, of whom 18 are medical oncologists.

Richard Friedman, CEO of BioScrip, spent much of his oral testimony summarizing issues with CAP and how to address them. He listed the following barriers and proposed solutions:

• Lack of on-site inventory → Supply physicians’ offices with limited inventory for emergencies


• Must ship to site of drug administration → Permit shipments to multiple locations designated by MDs


• Added MD billing requirements → MDs bill for administrative fee only


• Patient copay concerns → Enable MDs to support copay for beneficiaries on a case-by case basis


• Physician need for education about CAP → Allow MD open enrollment