Biosimilars Forum Applauds Senators Roberts, Carper for Leadership on Proposed Medicare Rule on Biosimilar Coding

Proposed CMS Ruling Could Reduce the Amount of Treatment Options
Health Care Providers Provide to Patients

WASHINGTON, DC, October 8, 2015 – The Biosimilars Forum today expressed support for Senators Pat Roberts (R-KS) and Tom Carper (D-DE) as well as 18 additional Senators for their leadership in sending a letter to Andrew Slavitt, Acting Administrator for the Centers for Medicare & Medicaid Services (CMS) regarding the provisions relating to biosimilar reimbursement in the CMS’s 2016 Medicare Physician Fee Schedule proposed rule. This letter follows the bipartisan House letter that was sent to Slavitt in July. You can read the proposed rule here and the Senate letter here.

“The House, Senate and countless stakeholders have now made their concerns clear that multiple biosimilars being grouped and issued the same J-code for Medicare reimbursement purposes could result in fewer biosimilars being introduced in the United States, and ultimately in fewer treatment options for health care professionals and patients,” said Michael Werner, Biosimilars Forum policy advisor. “The Biosimilars Forum shares this concern. Under this proposed rule, thousands of patients facing serious diseases and disorders who are expected to benefit from biosimilars may have limited access to treatments and therapies offered by their health care professionals.”

“We are pleased that this issue is being addressed now by both the House and the Senate, and applaud those who are working to correct the proposed regulation to reflect the intent of Congress and the BPCIA’s biosimilar payment and coding requirements. We urge CMS to revise its proposed rule for Part B to better reflect the law and to support this new industry by giving each biosimilar of the same reference product its own, unique Medicare claims code and payment amount,” Werner concluded.

About the Biosimilars Forum

The Biosimilars Forum is a nonprofit organization whose mission is to advance biosimilars in the United States with the intent of expanding access and availability of biological medicines, and improving health care. The founding members of the Biosimilars Forum represent the majority of companies with the most significant U.S. biosimilars development portfolios.

To learn more about biosimilars, the Forum, and how to get involved, visit or go to @USBiosimilars to follow related conversations and join the dialogue.

Aimee Steel

Lynn Blenkhorn