Medicare Part B Competitive Acquisition Program (CAP)

Effective October 1, 2006, Thyrogen^® (thyrotropin alfa for injection) has been added to the list of drugs available under the Medicare Part B Competitive Acquisition Program (CAP). As a result, Thyrogen can now be ordered for your Medicare-covered patients through BioScrip, the approved CAP vendor, who will bill the drug claim directly to Medicare. Participation in the CAP program requires enrollment. If you are already enrolled in CAP for 2006, you will have access to Thyrogen under this program beginning October 1, 2006. If you are not yet enrolled, you may participate in the program effective January 1, 2007 as long as you enroll during the open enrollment period which begins October 1, 2006 and ends November 15, 2006.

Benefits of Enrolling in CAP

The primary benefit of enrolling in CAP is that you will no longer have to buy and bill for Thyrogen under the Average Sales Price (ASP) system. Additional benefits of enrolling in CAP include reduced time and paperwork. BioScrip's team of CAP specialists will assume the Medicare billing process for Thyrogen, collecting any applicable Thyrogen-related deductibles and coinsurance from beneficiaries – leaving you responsible only for ordering the drug and billing for physician services associated with administering Thyrogen in the office setting. If you choose to enroll in CAP, you must obtain all drugs on the CAP drug list from BioScrip.

How to Enroll in the 2007 CAP

1. Complete the CAP Physician Election Agreement Form for 2007. This form can be downloaded from the Centers for Medicare and Medicaid Services (CMS) CAP website or from the BioScrip website. You can also contact BioScrip at (866) 366-7915 for a copy of the form. Please note that if a physician group practice using a group billing number elects to participate in the CAP, all physicians in the group elect to participate in the CAP when billing under the group billing number.

2. 2007 CAP enrollment begins October 1, 2006 and ends November 15, 2006. In order to participate in CAP during 2007, you must enroll during this period.

3. Your completed election agreement must be postmarked no later than November 15th and returned to your local Medicare carrier. A listing of all local Medicare carriers can be found on the CMS CAP website.

Additional Information on CAP

Additional information on CAP and the 2007 CAP enrollment process can be obtained by visiting the CMS CAP website or by visiting the BioScrip website. You can also contact the BioScrip CAP hotline at (866) 366-7915.

Read the Genzyme CAP press release (PDF).