Last month, the Centers for Medicare and Medicaid Services (CMS) sent a transmittal to every state Medicaid agency in the country clarifying the National Drug Code (NDC) reporting requirements applicable to hospitals when billing Medicaid for infusion products, injectables and other physician administered drugs.  Issuance of the transmittal represents the culmination and conclusion of a lawsuit brought by SNHPA and a member hospital more than a year ago challenging CMS’s interpretation of a 2005 federal law directing states to collect NDCs for physician administered drugs.  As explained in more detail in the attached documents, CMS has acknowledged, for the first time, that states have the authority to exempt all or a subset of hospital clinic drugs from the NDC reporting requirements without risking the loss of federal matching funds.  This development creates a significant opportunity to work with their states to implement this newly-recognized exemption. 

SNHPA's NDC Reporting Advovacy Packet should provide you with all the information necessary to educate your state about the CMS clarification. 

Please contact Stuart Gordon at stuart.gordon@snhpa.org or 202-552-5851 for additional information.